Efficacy of the combination of Q‐switched Nd:YAG laser and microneedling for melasma

Köse, Özlem Karadağ; Borlu, Murat

doi:10.1111/jocd.13629

Cited by 12 publications

(12 citation statements)

References 26 publications

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“…Hypermelanosis are characterized by the accumulation of melanin at different levels of the skin. The mechanism of the Q-Switched laser primarily relies on the photomechanical effect to destroy the targeted tissue, accompanied by a diminished photothermal effect [ 10 , 11 , 12 ]. Hypermelanoses should be treated with lasers only when malignancy risk is excluded.…”

Section: Discussionmentioning

confidence: 99%

Nanosecond Q-Switched 1064/532 nm Laser to Treat Hyperpigmentations: A Double Center Retrospective Study

Nisticò

Cannarozzo

Provenzano³

et al. 2021

Clinics and Practice

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(1) Benign hyperpigmentations are a common problem in cosmetic dermatology. Melasma, solar lentigo, and other acquired hyperpigmentations represent an aesthetic issue for an increasing number of patients. The gold standard in managing this condition is currently 1064/532 nanometers (nm) Q-Switched lasers. This study reports our experience on the use of a Q-switched laser with a nanosecond pulse to treat these conditions. (2) Methods: A total of 96 patients asking for benign hyperpigmentation removal were consecutively enrolled at the Magna Graecia University of Catanzaro and Tor Vergata University of Rome. Treating parameters were the following: 1064 nm with a pulse duration of 6 nanoseconds (ns) for dermic lesions and 532 nm with 6 ns for epidermal ones. Up to five treatments with a minimum interval between laser treatments of thirty days were performed. A follow-up visit three months after the last session assessed patient satisfaction with a Visual Analogue Scale (VAS). Two blinded dermatologists assessed the cosmetic result using a five-point scale comparing pictures before treatment and at follow-up. (3) Results: 96 patients were included; 47 participants were women (49.0%) and 49 men (51.0%). The mean reported age was 50.0 ± 17.3 years. All patients reached a good to complete hyperpigmentation removal at the dermatological evaluation with a mean VAS score of 8.91 ± 1.07. (4) Conclusions: Q Switched 1064/532 nm laser may be considered the gold standard treatment for benign hyperpigmentations. Our results confirm the literature findings on the effectiveness of these devices.

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Section: Discussionmentioning

confidence: 99%

Nanosecond Q-Switched 1064/532 nm Laser to Treat Hyperpigmentations: A Double Center Retrospective Study

Nisticò

Cannarozzo

Provenzano³

et al. 2021

Clinics and Practice

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“…Moreover, there was no significant difference between two groups regarding recurrence rate and adverse effects 18 . Two subsequent prospective uncontrolled open‐label studies showed significant improvement in melasma with triple combination of QSNY with either microneedling and mesotherapy or microdermabrasion and HQ 20,21 …”

Section: Discussionmentioning

confidence: 96%

“…Ablative devices lead to enhancement of TDD, transepidermal melanin extraction, improvement in dermal elastin tissue, neocollagenesis, basal membrane stabilization, and as a result less contact of keratinocytes and melanocytes with melanogenic dermal stimulators and ultimately less noticeable pigmentation. There were seven articles about combination of QSNY with ablative treatment modalities including FEYL, microneedling, microdermabrasion, and chemical peels 17,18,20‐23 …”

Section: Discussionmentioning

confidence: 99%

“…Heat caused by laser can lead to vasodilatation and better penetration of lightening drugs through micro channels created by microneedling 21 . On the other hand, microneedling of whole face leads to blending of melasma with surrounding skin and more homogenized skin 18‐21 . In one double blind RCT, Ustuner et al showed significantly higher percentage in MASI‐50 in combination of QSNY with microneedling plus vitamin C in comparison to QSNY alone (56.25% vs 12.5%, respectively).…”

Section: Discussionmentioning

confidence: 99%

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The efficacy of energy‐based devices combination therapy for melasma

Iranmanesh

Khalili

Mohammadi

et al. 2021

Dermatologic Therapy

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Melasma is a recalcitrant pigmentary disease with a complex pathogenesis. Monotherapy often results in unsatisfactory results with high recurrence rate. In this review article, we evaluate efficacy of energy‐based devices combination therapy for melasma. We reviewed published literature since 2010 up to November 2020 regarding adjuvant therapy of energy‐based devices with other treatment modalities in the treatment of melasma. After final selection, we assessed 49 articles. Energy‐based devices include lasers, non‐coherent lights, radiofrequency, iontophoresis, sonophoresis, microneedling, and microdermabrasion. Adjuvant therapies other than energy‐based devices were lightening agents, chemical peels, platelet rich plasma (PRP) and mesotherapy. Combination of Q‐switched neodymium‐doped: yttrium, aluminum, and garnet (QSNY) with either intense pulsed light therapy (IPL) or pulsed‐dye laser (PDL) are recommended in recalcitrant melasma in patients with light skin photo types and with dilated skin vessels (especially with PDL). Combination of fractional microneedling radiofrequency or microneedling with QSNY leads to promising results and is a safe treatment modality, especially in darker skin types. Application of topical lightening agents in combination with laser therapy leads to higher efficacy with less adverse effects (post‐inflammatory hyperpigmentation) and rebound of melasma. Combination of ablative techniques with QSNY is not recommended, due to the high risk of permanent adverse effects such as guttate hypopigmentation and exacerbation of melasma.

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“…We may define hyperpigmentations as the storage of a pigment such as melanin into the skin layers. Q-Switched lasers use the photomechanical effect to destroy the targeted chromophores, having no or minimal photothermal effect on surrounding tissues [13][14][15]. Only hyperpigmentations not associated with the risk of degeneration in malignancies should be treated with lasers; other hypermelanotic lesions, such as dysplastic nevi, should be handled with surgery.…”

Section: Discussionmentioning

confidence: 99%

Q-Switched 1064/532 nm Laser with Picosecond Pulse to Treat Benign Hyperpigmentations: A Single-Center Retrospective Study

et al. 2021

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(1) Benign melanoses are a frequent issue in aesthetic dermatology. Solar lentigo, ephelides, café au lait spots, and other melanoses represent a cosmetic issue for a growing number of subjects. The Q-switched 1064/532-nanometer (nm) laser may be considered the gold standard for management of these aesthetic issues. A new generation of Q-switched lasers, capable of concentrating the energy pulse in the spectrum of hundreds of picoseconds, is emerging, promising better results than previous ones. In this paper, we report the use of a Q-switched laser with a picosecond pulse to manage hypermelanoses. (2) Methods: 36 patients seeking melanosis removal were retrospectively enrolled at Magna Graecia University of Catanzaro. Treatment parameters, although variable, were the following: 1064 nm with a pulse duration of 450 picoseconds (ps) for dermic lesions and 532 nm with 370 ps for epidermal lesions. Up to four treatments, with a minimum interval between laser treatments of 30 days, were performed. After the last session, patients’ satisfaction was assessed at a three-month follow up with a Visual Analogue Scale (VAS). Two blinded dermatologists measured the aesthetic outcome using a five-point scale comparing pictures before laser sessions and during follow-up. (3) Results: 36 patients were enrolled; 23 were females (63.9%) and 13 males (36.1%). The mean reported age was 49.2 ± 18.9 years. All participants were assessed with a complete/almost complete melanosis removal at the dermatological evaluation, with a mean VAS score of 9.39 ± 0.90. (4) Conclusions: The Q-switched 1064/532 nm laser may be considered the main weapon in treating benign hypermelanosis. The picosecond pulse seems to guarantee better results than other devices. However, a clinical trial comparing Q-switched nanosecond pulse with picosecond pulse is necessary to confirm this study’s findings.

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Efficacy of the combination of Q‐switched Nd:YAG laser and microneedling for melasma

Cited by 12 publications

References 26 publications

Nanosecond Q-Switched 1064/532 nm Laser to Treat Hyperpigmentations: A Double Center Retrospective Study

Nanosecond Q-Switched 1064/532 nm Laser to Treat Hyperpigmentations: A Double Center Retrospective Study

The efficacy of energy‐based devices combination therapy for melasma

Q-Switched 1064/532 nm Laser with Picosecond Pulse to Treat Benign Hyperpigmentations: A Single-Center Retrospective Study

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