Treatment of café-au-lait macules with a high-fluenced 1064-nm Q-switched neodymium:yttrium aluminum garnet laser

Abstract

Café-au-lait macules (CALMs) are light to dark brown macules or patches of increased melanin concentration found along the dermoepidermal junction. Although many attempts to treat CALMs using various kinds of laser/light-based devices have been reported, CALMs remain refractory thereto with high recurrence rates. In this case series, we describe four patients with idiopathic CALMs that were effectively and safely treated with a non-ablative, high-fluenced, Q-switched (QS), 1064-nm neodymium:yttrium aluminum garnet (Nd:YAG) laser. The typical laser parameters for treating CALMs, including a spot size of 7-7.5 mm, a fluence of 2.4-2.5 J/cm, and one to two passes until the appearance of mild erythema, but not petechiae, were utilized in this study over 12-24 treatment sessions at 2-week intervals. We suggest that high-fluenced QS 1064-nm Nd:YAG laser treatment can be used as an effective and alternative treatment modality for CALMs with minimal risk of side effects.

Comparative Effectiveness of 755‐nm Picosecond Laser, 755‐ and 532‐nm Nanosecond Lasers for Treatment of Café‐au‐Lait Macules (CALMs): A Randomized, Split‐Lesion Clinical Trial

“…Many types of lasers have been used to treat CALMs to achieve cosmetic improvement, including the 510 nm pulsed dye laser [6]; 511 nm copper vapor laser [7]; 532 nm [8], 1064 nm Q‐switched Nd:YAG laser [9]; Q‐switched ruby laser [10]; Q‐switched Alexandrite laser [11]; and erbium: YAG laser [12]. As melanin particles show high absorption of laser energy at wavelengths of 532 and 755 nm, Q‐switched lasers at these wavelengths have been used more frequently [13,14]. Recently, the picosecond laser, which was initially developed for tattoo removal, has raised much interest owing to its excellent promise in treating nevus of Ota and acquired bilateral nevus of Ota‐like macules, compared with the Q‐switched Alexandrite laser [15,16].…”

High‐fluence 1064‐nm Q‐Switched Nd:YAG laser: Safe and effective treatment of café‐au‐lait macules in Asian patients

“…Side effects after laser treatment are more common in the skin of people of Asian descent than that of Caucasians. One of the authors has introduced a powerful treatment of CALMs using a high‐fluence 1064‐nm Q‐switched Nd:YAG laser to avoid both the side effects and recurrence in Asian patients . This study reports this method in 35 patients with CALMs because it is thought that more effective and safe results of treatment than conventional laser treatment can be expected.…”

Preliminary experience of the Q‐switched 1064‐nm neodymium:yttrium aluminum garnet laser in the treatment of Café‐au‐lait macules

“…[2][3][4][5][6][7] Based on the theory of selective photothermolysis, the Q-switched lasers were most accepted modality to remove CALMs with higher efficacy and minimal adverse effects. 8,9 We have introduced a powerful treatment of CALMs using a QS 1064 nm Nd: yttrium aluminum garnet (YAG) laser to avoid both the sideeffects and recurrence in Chinese patients. Data were collected from the records of CAML patients who received only QS 1064nm Nd:YAG laser.…”