Evaluating the Risk Factors of Post Inflammatory Hyperpigmentation Complications with Nd-YAG Laser Toning Using LASSO-Based Algorithm

Abstract

The neodymium-doped yttrium aluminum garnet (Nd-YAG) laser is used for removal of pigmented skin patches and rejuvenation of skin. However, complications such as hyperpigmentation, hypopigmentation, and petechiae can occur after frequent treatments. Therefore, identifying the risk factors for such complications is important. The development of a multivariable logistic regression model with least absolute shrinkage and selection operator (LASSO) is needed to provide valid predictions about the incidence of post inflammatory hyperpigmentation complication probability (PIHCP) among patients treated with Nd-YAG laser toning. A total of 125 female patients undergoing laser toning therapy between January 2014 and January 2016 were examined for post-inflammatory hyperpigmentation (PIH) complications. Factor analysis was performed using 15 potential predictive risk factors of PIH determined by a physician. The LASSO algorithm with cross-validation was used to select the optimal number of predictive risk factors from the potential factors for a multivariate logistic regression PIH complication model. The optimal number of predictive risk factors for the model was five: immediate endpoints of laser (IEL), α-hydroxy acid (AHA) peels, Fitzpatrick skin phototype (FSPT), acne, and melasma. The area under the receiver operating characteristic curve (AUC) was 0.79 (95% CI, 0.70–0.88) in the optimal model. The overall performance of the LASSO-based PIHCP model was satisfactory based on the AUC, Omnibus, Nagelkerke R2, and Hosmer–Lemeshow tests. This predictive risk factor model is useful to further optimize laser toning treatment related to PIH. The LASSO-based PIHCP model could be useful for decision-making.

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

“…Acquired hyperpigmentations and congenital ones are usually treated with 1064 nm Q-switched lasers; acquired pigmentation tends to have better results than the congenital counterpart [ 21 , 22 , 23 ]. Q-switched laser treatment is usually well tolerated.…”

Safety and efficacy of superficial micro‐focused ultrasound with visualization for melasma in Asians: An uncontrolled pilot study

“…The mean difference in mMASI from baseline at each monthly follow‐up was statistically significant and increased from 3.6 at 1 month to 10.4 at 5 months. Importantly, we found no incidence of side effects such as PIH, which occurs frequently with conventional treatments for melasma, including laser therapies 21 …”

“…Importantly, we found no incidence of side effects Mean mMASI (Top) and Differences in mMASI from Baseline (Bottom). such as PIH, which occurs frequently with conventional treatments for melasma, including laser therapies 21. Melasma is a common, acquired pigmentary condition that affects all races and ethnicities.…”

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

“…Although the 1064 wavelength usually gives better results to dermal melanosis, the outcome remains controversial in melasma, probably related to its poorly understood etiology [21][22][23]. Acquired hyperpigmentations seem to reach better cosmetic outcomes than their congenital ones [24][25][26]. Our study's findings suggest a significant efficacy of lasers in lentigo and other superficial lesions and lower phototypes.…”