Efficacy and Adverse Effects of Q-Switched Ruby Laser on Solar Lentigines: A Prospective Study of 91 Patients with Fitzpatrick Skin Type II, III, and IV

Abstract

Q-switched ruby laser treatment is a safe procedure for the treatment of solar lentigines even in dark-skinned individuals. Considering routine factors in addition to melanin content alone is required for minimizing side effects, especially postinflammatory hyperpigmentation in darker skin.

Treatment of Pigmented Lesions in the Asian Skin

“…Sadighha et al treated 91 patients with solar lentigines (skin types II-IV) with the Q-switched ruby laser (3 mm spot, fluence 8-16 J/cm 2 ) and noted complete clearance in all patients after one to two treatment sessions. 15 Post-inflammatory hyperpigmentation occurred in 7.8% of patients in skin type II, 9.8% in skin type III, and 16.6% in skin type IV. Hypopigmentation was seen in one patient and all pigmentary changes improved over six months.…”

Benign Acquired Superficial Skin Lesions of the Hand

“…9 However, laser therapy using a pigment-specific laser (ie, Q-switched ruby, alexandrite, neodymium-yttrium-aluminum-garnet [Nd: YAG]) has yielded better results, often with complete clearance of lentigines in 1 to 2 treatment sessions. 10 All of these therapies can have postinflammatory dyspigmentation as a side effect, so it is important to counsel patients on this possibility.…”

Laser Treatment of Dark Skin

“…If the clinical threshold is exceeded, epidermal exfoliation and pinpoint bleeding ensues, resulting in blistering, possible temporary or permanent hypopigmentation, and the higher probability of skin textural changes or scarring. [13] Even when optimal parameters are applied, one of the most common adverse effects associated with QS laser treatment in dark-skinned individuals is post-inflammatory hyperpigmentation (PIH). Although the exact mechanism for PIH is unknown, direct melanin stimulation following laser impact is thought to be involved.…”