A randomized, split-face clinical trial of low-fluence Q-switched neodymium-doped yttrium aluminum garnet (1,064 nm) laser versus low-fluence Q-switched alexandrite laser (755 nm) for the treatment of facial melasma

Fabi, Sabrina G.; Friedmann, Daniel P.; Massaki, Ane B. Niwa; Goldman, Mitchel P.

doi:10.1002/lsm.22263

Cited by 52 publications

(58 citation statements)

References 24 publications

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“…Since 2007, 1064‐nm Q‐switched neodymium‐doped yttrium aluminium garnet (QS‐Nd:YAG) laser toning has been commonly prescribed for the treatment of melasma . However, in Asians, this treatment typically only produces temporary improvements along with certain side‐effects such as recurrence, hypopigmentation and rebound hyperpigmentation .…”

Section: Introductionmentioning

confidence: 99%

Prospective randomized controlled trial comparing treatment efficacy and tolerance of picosecond alexandrite laser with a diffractive lens array and triple combination cream in female asian patients with melasma

Wang

Lin

Chen

et al. 2019

Acad Dermatol Venereol

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Background Recent evidence suggests melasma to be a photoaging disorder. Triple combination creams (TCC: fluocinolone acetonide 0.01%, hydroquinone 4% and tretinoin 0.05%) remain the gold standard treatment. Picosecond alexandrite laser treatment using a diffractive lens array (DLA) has been identified to be effective for improving photoaging conditions. Objective We aimed to compare the efficacy and tolerance of the picosecond alexandrite laser with those of DLA and TCC in female Asian patients with melasma. Methods Twenty‐nine patients were randomly assigned to group A1 (3 laser sessions at 4‐week intervals), A2 (5 laser sessions at 4‐week intervals) or B (TCC daily for at least 8 weeks and then tapered until the final evaluation). The Melasma Area, Severity Index (MASI) score and VISIA were assessed at baseline, week 12 and week 20. By week 20, the follow‐up periods for groups A1 and A2 were 3 months and 1 month, respectively. Results Nine, 11 and 6 participants in groups A1, A2 and B completed the study, respectively. MASI scores were significantly improved in all 3 groups at weeks 12 and 20. In groups A1, A2 and B, the improvement rates at week 20 were 53%, 38% and 50%, respectively. VISIA® analysis additionally revealed a significant improvement in spots, porphyria, pores and brown spots after 3 laser sessions (P < 0.05). Group A2 showed greater improvements than group A1 in terms of spots, wrinkles and pores; however, only red areas were significantly different (P < 0.001). All side‐effects in the 3 groups were transient and gradually subsided after 1–3 months. Conclusion Picosecond alexandrite laser treatment using DLA showed comparable efficacy with TCC for the treatment of melasma. Improvements in texture, spots, wrinkles and pores were observed in the laser groups. Patients with melasma lesions that exhibit telangiectasia may benefit from additional laser treatment sessions.

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Section: Introductionmentioning

confidence: 99%

Prospective randomized controlled trial comparing treatment efficacy and tolerance of picosecond alexandrite laser with a diffractive lens array and triple combination cream in female asian patients with melasma

Wang

Lin

Chen

et al. 2019

Acad Dermatol Venereol

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“…Furthermore, while topical therapies may be effective for epidermal melasma, it is noticed that dermal and mixed types are commonly refractory to topical monotherapy because of their deeper pigments. Energy-based devices appear as alternatives to help dealing with resistant melasma circumstances [10] . Lasers have transformed the treatment of many conditions in dermatology, as well as in pigmentary pathologies.…”

Section: Melasma and Energy-based Devicesmentioning

confidence: 99%

“…In addition, no increased adverse events were seen with QSAL. Therefore, it is important not to overlap or accidentally pulse stack when using the QSAL, because it could overstimulate melanocytes more easily than the 1064-nm QSNY could [10] .…”

Section: Q-switched Lasersmentioning

confidence: 99%

Energy-based devices for treatment of melasma

Jordão

Rebellato

2017

J Surg Dermatol

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Melasma, as a pigmentation disorder, induces significant stress to the patients and its recurrent nature remains a challenge in clinical practice. Treatment is based on a variety of mechanisms to prevent and/or stop the pigment production process by destroying the deposited pigment for removal or release, by peeling cells to improve their turnover, and by reducing inflammation. The use of appropriate devices and correct settings are crucial in the treatment of melasma. Cases unresponsive to topical bleaches or chemical peels should be referred for laser therapy. It is important that a maintenance therapy to avoid the recurrence of melasma be indicated. In this paper, we review energy-based devices for melasma treatment.

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“…Lowfluence Q-switched Nd: YAG laser, that seems to have acquired the status of 'gold standard' among lasers in melasma by virtue of a lower incidence of inducing PIH (though its effectiveness is as short-term as all other lasers), is the one against which all the new lasers are tested for comparative efficacy and safety. Low-fluence Q-switched alexandrite laser (755 nm) was found to be of equal effectiveness [52]. and lowpower fractional carbon dioxide (CO 2 ) laser significantly more effective than low-fluence Q-switched Nd: YAG laser (1, 064 nm) [53].…”

mentioning

confidence: 96%

Agenda for Future Research in Melasma: QUO VADIS?

Panda¹

2014

Pigmentary Disorders

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A randomized, split-face clinical trial of low-fluence Q-switched neodymium-doped yttrium aluminum garnet (1,064 nm) laser versus low-fluence Q-switched alexandrite laser (755 nm) for the treatment of facial melasma

Abstract: This was a single-center trial and patients were not able to use complimentary lightening agents during the study.

Cited by 52 publications

References 24 publications

Prospective randomized controlled trial comparing treatment efficacy and tolerance of picosecond alexandrite laser with a diffractive lens array and triple combination cream in female asian patients with melasma

Prospective randomized controlled trial comparing treatment efficacy and tolerance of picosecond alexandrite laser with a diffractive lens array and triple combination cream in female asian patients with melasma

Energy-based devices for treatment of melasma

Agenda for Future Research in Melasma: QUO VADIS?

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