Melasma is a common condition affecting over six million American women. Treatment of dermal or combined melasma is difficult and does not respond well to conventional topical therapies. Various light sources have been used recently in the treatment of melasma including fractionated ablative and non-ablative lasers as well as intense pulse light. We report the use of low fluence, large spot size Q-switched, Nd:Yag laser for the treatment of melasma in skin types II-IV.

The use and success of high-energy, short-pulse, Q-switched lasers for tattoo removal has been well demonstrated. Three types of lasers are currently commercially available for tattoo removal: the Q-switched ruby laser (694 nm), the Q-switched alexandrite laser (755 nm) and the Q-switched Nd:YAG laser (532 nm and 1064 nm). Multiple parameters such as tattoo type, color, location, and patient skin type dictate which laser is optimal in each patient. Despite the demonstrated efficacy of these modalities, there are few papers that address some of the long-term issues of tattoo removal, such as patient compliance, and how these issues impact on the success rates of optimal tattoo removal treatments. In this retrospective study, 10-year data from a single center are presented. Our data include parameters such as clearance rates, number of treatments, wavelength of the utilized laser, and fluence and spot-size setting. In addition, potential complications such as scarring, hypopigmentation, and pain were analyzed. Finally, we examine the patient compliance that accompanied tattoo removal and the reasons behind the typically low success rates for total tattoo clearance.

With the advancement in laser technology, there has been a recent trend in laser and light devices towards 'do it yourself' at-home use. There has been an exponential growth in devices aimed at the treatment of acne, hair removal, and psoriasis. With the exception of the at-home UVB box and excimer lasers, these systems do not require a prescription and patients may purchase the systems as over-the-counter products. Medical treatment still remains the standard of care for most conditions, but these at-home devices play a significant role in the treatment of various conditions. Media and marketing have driven the popularity of these devices and have encouraged patients to try them out. Patients are attracted to at-home devices because of the one-time cost, ease of use, convenience, and privacy of use. Naturally, despite these devices being for at-home use, there should be a level of caution adhered to when using any laser or light device.

No abstract