A randomized, observer-blinded, comparison of combined 1064-nm Q-switched neodymium-doped yttrium–aluminium–garnet laser plus 30% glycolic acid peel vs. laser monotherapy to treat melasma

Park, K. Y.; Kim, D. H.; Kim, H. K.; Li, K.; Seo, Sang Woo; Hong, Chang Kwun

doi:10.1111/j.1365-2230.2011.04150.x

Cited by 55 publications

(60 citation statements)

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“…Previous reports showed promising results for melasma treatment. Post-inflammatory hyperpigmentation rarely occurred with the 1,064-nm QS-Nd:YAG laser as its power is delivered in a non-ablative modality [6]. Based on examination with a Wood's lamp, melasma can be classified into epidermal, dermal, and mixed type.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of melasma with mixed parameters of 1,064-nm Q-switched Nd:YAG laser toning and an enhanced effect of ultrasonic application of vitamin C: a split-face study

et al. 2014

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Melasma is an acquired pigment disorder showing symmetrical hyperpigmentation of the face characterized by light to dark brown patches with indistinct borders on both cheeks. Melasma is prevalent in middle-aged women with harmless hormone imbalances. It is also known as the mask of pregnancy and is prevalent in most child-bearing women. It fluctuates month by month, and yet, there is no promising treatment. The Q-switched neodymium-doped yttrium aluminum garnet (QS-Nd:YAG) laser (1,064-nm wavelength) was introduced in Asia years ago for both skin toning and treatment of facial pigment. This low-fluence, 1,064-nm QS-Nd: YAG laser also reportedly improved melasma. Adjunctive treatments such as vitamin C iontophoresis or chemical peels were recommended in other reports. The technique using the 1,064-nm QS-Nd:YAG laser for toning and the enhancement of adjunctive treatments need further investigation and long-term follow-up before recommendations for the ideal protocol for melasma treatment can be made. The aim of this study is to evaluate the improvement of melasma using different parameters with the 1,064-nm QS-Nd:YAG laser with ultrasonic application of topical vitamin C. Eight patients, ranging in age from 32 to 45 years (mean 37 years), with long-term melasma were studied. Most of the melasma cases were dermal or mixed-type melasma. The patients had no cosmetic treatment (laser, intense pulsed light, or chemical peel) 1 year prior to the study. The entire face of each patient was treated with the 1,064-nm QS-Nd:YAG laser for four sessions at 1-month intervals. The laser treatment was divided into three parts with different parameters. First, each patient underwent whole face exposure for one pass with an 8-mm spot size at a power of 2.0 J/cm(2). Next, the spot size was shifted to 6 mm at a power of 3.5 J/cm(2) for one full-face pass, and then ended with a 4-mm spot size at 3.2 J/cm(2) for one full-face pass, with multiple passes for the main lesions. The end point was mild erythema and swelling, without petechiae. All patients applied ice packs for 5 min before the adjunctive treatment. We designed a split-face study with or without ultrasonic application of topical vitamin C. Only the right side of the face received ultrasonic melasma application of vitamin C for 15 min after ice packing. The left side of the face was covered with a moisturizing lotion. Objective evaluation was performed with visual analog score. All eight patients completed the 3-month follow-up after the four laser treatments. Statistics showed significant improvement with ultrasonic application of vitamin C compared to laser monotherapy. The improvement was more pronounced during second to fourth sessions. There was no rebound or post-inflammatory hyperpigmentation detected during the 3-month follow-up period. The combination of 1,064-nm QS-Nd:YAG laser treatment with ultrasonic application of topical vitamin C exerted more prompt response of melasma. We recommended this protocol including mixed parameters of 1,064-nm QS-Nd:YAG laser toning ...

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Section: Discussionmentioning

confidence: 99%

“…This discolored appearance can cause significant psychological distress and decrease quality of life [1]. A 1,064-nm Q-switched neodymium-doped yttrium aluminum garnet laser (QS-Nd: YAG) has been used for treatment of melasma with promising results [2][3][4][5][6]. Topical vitamin C inhibits melanin formation and reduces oxidized melanin.…”

Section: Introductionmentioning

confidence: 99%

Treatment of melasma with mixed parameters of 1,064-nm Q-switched Nd:YAG laser toning and an enhanced effect of ultrasonic application of vitamin C: a split-face study

et al. 2014

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“…We read with interest the study of Kar, et al [1] and considering the studies using lasers and triple combination creams (TC) [2][3][4][5] and the continued, invariably futile attempt to tackle this recalcitrant disorder, we feel it is time to focus on the relative merits of various modalities in melasma. The fundamental assessment criterion of the largely subjective (melasma area severity index, MASI) and the objective (Mexameter) assessment is crucial for logical interpretation of results, but probably more important is the pigment in the skin which makes a huge difference in the results of any laser in pigmented skin [6] including melasma.…”

Section: Sirmentioning

confidence: 96%

“…These results contrast with a similar study in Korean patients who have a markedly lighter skin tone than Indian skin. [2] Here, a split face design was used to compare the effects of glycolic acid (GA) peel with Qsw Nd: YAG lasers versus the GA peel group. This study in a Korean population (a lighter skin type) [2] should have logically delivered superior results but only a 32.6-37.4% improvement using the Mexameter readings and modified MASI was seen, compared with 22% and 16.7%, respectively, with the laser only.…”

Section: Sirmentioning

confidence: 99%

“…[2] Here, a split face design was used to compare the effects of glycolic acid (GA) peel with Qsw Nd: YAG lasers versus the GA peel group. This study in a Korean population (a lighter skin type) [2] should have logically delivered superior results but only a 32.6-37.4% improvement using the Mexameter readings and modified MASI was seen, compared with 22% and 16.7%, respectively, with the laser only. This study was a split face study and used an objective tool and the paradoxically superior results in Indian skin using just the pigment laser (40.44% [1] vs. 22% [2] ) and the even more remarkable results in the peel group [1] (40.44%) could be partly due to the subjective assessment tool, MASI.…”

Section: Sirmentioning

confidence: 99%

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Which therapy works for melasma in pigmented skin: Lasers, peels, or triple combination creams?

Sardana

Chugh

Garg

2013

Indian J Dermatol Venereol Leprol

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Energy-Based Facial Rejuvenation

Britt

Marcus

2017

JAMA Facial Plast Surg

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he term laser originated from an acronym that stands for light amplification by stimulated emission of radiation. Its use is a cornerstone for today's facial plastic surgeon (Figure 1). The landmark article by Anderson and Parrish 1 in 1983 on selective photothermolysis began the era of laser-therapy skin rejuvenation. These techniques were expanded on by Manstein et al 2 in the seminal article on fractional photothermolysis in 2004. This leap in laser technology reduced scarring by using microscopic treatment zones used to promote tissue remodeling and ushered in an era in minimal downtime after laser therapy. Over the past decade, laser technology, in addition to intense pulsed light (IPL), radiofrequency devices, and focused high-frequency ultrasonography technologies, has increased options for patients in facial rejuvenation, resurfacing, and tightening.With the advent of such technologies, both supply and demand have increased at incredible speeds. According to the American Society for Plastic Surgery statistics, which provide a compre-hensive estimate on the total number of cosmetic procedures performed in the United States, minimally invasive cosmetic procedures laser resurfacing procedures have increased by more than 200% since 2000. In 2014, more than 540 000 laser skinresurfacing procedures were performed with a 6% increase from 2013, 87% of which were performed in women. 3 These statistics do not include the large number of non-laser-based products used for facial rejuvenation and tightening or light-based facial rejuvenation technologies. With the ever-expanding repertoire of technology and products, it is important to understand the efficacy of each to match the demand. MethodsWe performed a review of PubMed from 2011 to 2016 using specific search strategies, modeled after systematic reviews but con-IMPORTANCE The market for nonsurgical, energy-based facial rejuvenation techniques has increased exponentially since lasers were first used for skin rejuvenation in 1983. Advances in this area have led to a wide range of products that require the modern facial plastic surgeon to have a large repertoire of knowledge.OBJECTIVE To serve as a guide for current trends in the development of technology, applications, and outcomes of laser and laser-related technology over the past 5 years.

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A randomized, observer-blinded, comparison of combined 1064-nm Q-switched neodymium-doped yttrium–aluminium–garnet laser plus 30% glycolic acid peel vs. laser monotherapy to treat melasma

Abstract: Combined 1064 QNYL and GA seems to be superior to 1064 QNYL alone in the treatment of mixed-type melasma.

Cited by 55 publications

References 18 publications

Treatment of melasma with mixed parameters of 1,064-nm Q-switched Nd:YAG laser toning and an enhanced effect of ultrasonic application of vitamin C: a split-face study

Treatment of melasma with mixed parameters of 1,064-nm Q-switched Nd:YAG laser toning and an enhanced effect of ultrasonic application of vitamin C: a split-face study

Which therapy works for melasma in pigmented skin: Lasers, peels, or triple combination creams?

Energy-Based Facial Rejuvenation

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