Efficacy and Safety of Topical Silymarin Versus Low Fluence 1064‐nm Q Switched Nd:YAG Laser in the Treatment of Melasma: A Comparative Randomized Trial

Ibrahim, Samir; Farag, Asmaa S.; Ali, Mona S; El-Gendy, Wafaa M A F

doi:10.1002/lsm.23440

Cited by 10 publications

(16 citation statements)

References 20 publications

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“…Severe adverse events were rarely reported in both treatment groups [ 46 ]. In a study comparing LFQSNY and topical silymarin cream, there was no significant difference in the reduction in mMASI score and the incidence of adverse effects in both groups [ 14 ]. Dev T. et al reported that there was no significant difference in the reduction in mMASI, MI score, and subjective evaluation of patients between LFQSNY and TC cream [ 18 ].…”

Section: Resultsmentioning

confidence: 99%

The Low-Fluence Q-Switched Nd:YAG Laser Treatment for Melasma: A Systematic Review

Lee

et al. 2022

Medicina

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Melasma is a common pigmentary disorder with a complex pathogenesis, of which the treatment is challenging. Conventional treatment often leads to inconsistent results with unexpected pigmentary side effects and high recurrence rates. Recently, the low-fluence Q-switched Nd:YAG laser (LFQSNY) has been widely used for treating melasma, especially in Asia. We reviewed literatures on the LFQSNY treatment of melasma published between 2009 and May 2022 to evaluate the efficacy and adverse events, including its combination therapy. A systematic PubMed search was conducted and a total of 42 articles were included in this study. It was hard to summarize the heterogenous studies, but LFQSNY appeared to be a generally effective and safe treatment for melasma considering the results of previous conventional therapies. However, mottled hypopigmentation has been occasionally reported to develop and persist as an adverse event of LFQSNY, which may be associated with the high accumulated laser energy. When used aggressively, even LFQSNY can induce hyperpigmentation via unwanted inflammation, especially in darker skin. Although few studies have reported considerable recurrence rates three months after treatment, unfortunately, there is a lack of the long-term follow-up results of LFQSNY in melasma. To enhance the effectiveness and reduce the adverse events, LFQSNY has been used in combination with other treatment modalities in melasma, including topical bleaching agents, oral tranexamic acid, chemical peeling, or diverse energy-based devices, which generally reduced side effects with or without significant superior efficacy compared to LFQSNY alone.

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Section: Resultsmentioning

confidence: 99%

The Low-Fluence Q-Switched Nd:YAG Laser Treatment for Melasma: A Systematic Review

Lee

et al. 2022

Medicina

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“…This new technique has been used with LQSNY (<3 j/cm 2 ), 1–2 weeks treatment intervals, increased treatment passes, and large spot size and leads to less inflammation and adverse effects 10 . The use of LQSNY has been proven to be an effective and safe therapy for moderate to severe dermal and mixed‐type melasma by decreasing the number of melanosomes, reducing the expression of melanogenesis‐associated proteins (TRP‐1 and TRP‐2), and reducing melanogenic stimulators (α‐MSH and NGF) 26,27 . Besides, LQSNY stimulates collagen formation along with the resulting dermal damage, allowing for brighter and tighter skin 28 .…”

Section: Discussionmentioning

confidence: 99%

“…10 The use of LQSNY has been proven to be an effective and safe therapy for moderate to severe dermal and mixed-type melasma by decreasing the number of melanosomes, reducing the expression of melanogenesis-associated proteins (TRP-1 and TRP-2), and reducing melanogenic stimulators (α-MSH and NGF). 26,27 Besides, LQSNY stimulates collagen formation along with the resulting dermal damage, allowing for brighter and tighter skin. 28 Although melanin absorbs less LQSNY than green and red light lasers, this longer wavelength can penetrate deeper skin without damaging the epidermis.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of low‐fluence 1064 nm Q‐switched Nd: YAG laser for the treatment of melasma: A meta‐analysis and systematic review

Chen

Peng

et al. 2022

J of Cosmetic Dermatology

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Background: Melasma is considered as a type of acquired facial pigmentary disorder that is challenging to treat. Low-fluence 1064 nm Q-switched Nd: YAG laser (LQSNY) has clinical benefits against melasma; however, there are some disputes.Objective: To explore these contentious views, we conducted a meta-analysis and systematic review to evaluate the efficacy and safety of LQSNY monotherapy and combined therapy for the treatment of melasma. Methods:The PubMed, Embase, Cochrane Library, and Web of Science databases were searched for relevant articles from inception to July 2021. The resulting data were analyzed using the Review Manager 5.3 software. Results:Twelve eligible studies comprising 358 patients were included. No significant differences in melasma area and severity index (MASI) were observed between the LQSNY and drug groups (mean difference (MD):−0.26, 95% confidence interval (CI):−1.16-0.64, p = 0.57). We found that combination therapy with LQSNY and drugs had a greater MASI improvement compared with LQSNY therapy alone (MD: 1.78, 95% CI 0.93-2.63, p < 0.0001); nevertheless, no statistically significant results were found in melanin index (MI) and self-assessment. The melasma improvement was similar when using LQSNY alone and LQSNY combined with other lasers in terms of RMASI (MD 0.05, 95% CI:−0.61, 0.70, p = 0.56). Compared with intense pulsed light (IPL) alone, LQSNY with IPL provided an added benefit for melasma severity (MD:3.23, 95% CI:0.65-5.81, p = 0.01). Conclusion:Low-fluence 1064 nm Q-switched Nd: YAG laser can be applied as an alternative treatment for drug intolerance. Combination therapy with LQSNY and drugs or other lasers may have pleasantly surprising efficacy, but numerous studies are still needed to verify this.

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“…Obtaining a P value < 0.05 supports statistically significant differences. The Mann–Whitney test is used for comparison between two groups having quantitative variables that are not normally distributed [ 86 ]; likewise, it is a robust competitor of the t-test in the univariate setting [ 87 ].…”

Section: Methodology and Methodsmentioning

confidence: 99%

Influence of product selection criteria on clothing purchase and post-purchase behaviours: A gender and generational comparison

Barrera-Verdugo

Villarroel-Villarroel

2022

PLoS ONE

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Purchasing and consumption behaviour is a factor with an important impact on sustainable development. In this regard, the clothing category plays a key role due to the high volume of products that are manufactured in countries with poor environmental and social conditions. While some research has investigated personal, social and cultural conditions that influence these behaviours, little is currently known about the influence of the attributes of sustainable clothing selection on the frequency of sustainable purchase and post-purchase actions in this category. This research seeks to evaluate this effect by comparing the results among genders and age/generation and measuring sustainable consumption using the Young Consumers’ Sustainable Consumption Behaviour method, which has two dimensions: purchase choices and sufficient and frugal consumption. Responses to online surveys of 240 university students in Chile are analysed using descriptive statistics, the Mann-Whitney-Wilcoxon test and ologit regressions. The findings show significant differences between the groups analysed with respect to the influence of attributes for sustainable clothing selection and highlight the negative effect of the search for quality in men and in older people. The evidence highlights the need to inform the population about the characteristics of sustainable clothing that positively affect purchase and post-purchase actions such as buying secondhand clothing, repairing, exchanging and donating clothing. This study also suggests that it is important to strengthen the relationship between sustainability and clothing quality among older generations and men.

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Efficacy and Safety of Topical Silymarin Versus Low Fluence 1064‐nm Q Switched Nd:YAG Laser in the Treatment of Melasma: A Comparative Randomized Trial

Cited by 10 publications

References 20 publications

The Low-Fluence Q-Switched Nd:YAG Laser Treatment for Melasma: A Systematic Review

The Low-Fluence Q-Switched Nd:YAG Laser Treatment for Melasma: A Systematic Review

Efficacy of low‐fluence 1064 nm Q‐switched Nd: YAG laser for the treatment of melasma: A meta‐analysis and systematic review

Influence of product selection criteria on clothing purchase and post-purchase behaviours: A gender and generational comparison

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