Combination of Q-Switched Nd:YAG and Fractional Erbium:YAG Lasers in Treatment of Melasma: A Randomized Controlled Clinical Trial
Journal of Lasers in Medical Sciences,
Vol. 8 No. 1 (2017),
25 January 2017
,
Page 1-6
Abstract
Introduction: Ablative and nonablative lasers have been used to treat melasma. We aimed to assess and compare the combining Q-switched Nd:YAG laser (QSNYL) and fractional erbium:YAG laser (FEYL) with QSNYL alone in treatment of melasma.
Methods: This randomized controlled clinical trial was performed in our Research Center during 2013-2014. Women with melasma and without a history of keloid formation, hypersensitivity to hydroquinone, or pigmentary changes due to laser therapy were randomly allocated to receive four sessions of either QSNYL-FEYL combination or QSNYL alone. All patients received topical treatment with Kligman’s formula. Before laser therapy and 4 weeks after the last treatment session, patients’ skin was assessed for changes in skin color, melanin content, and erythema intensity of melasma lesions quantitatively.
Results: Finally, 21 patients in QSNYL-FEYL and 20 in QSNYL group (mean age, 38.57 [5.60] and 42.60 [8.44] years, respectively) completed study. The skin color had become lighter in both groups (mean [SD] percentage change of 56.95 [40.29] and 29.25 [13.20] in QSNYL-FEYL and QSNYL groups, respectively) with significantly better results in QSNYL-FEYL group (P = 0.006). Percentage of decrease of melanin content was significantly higher in QSNYL-FEYL group (22.01 [10.67] vs. 7.69 [4.75]; P < 0.001). After adjustment for baseline values, the post treatment intensity of erythema was significantly lower in QSNYL-FEYL group (P < 0.001). The patients reported no adverse events.
Conclusion: QSNYL-FEYL was significantly more effective in decreasing melanin content of lesions than QSNYL and led to a lighter skin.
- Melasma
- Melanosis
- Lasers
- Solid-State
- Erbium-Doped Yttrium Aluminum Garnet Lasers
- Neodymium Doped Yttrium Aluminum Garnet Lasers
How to Cite
References
Ball Arefiev KL, Hantash BM. Advances in the treatment of melasma: a review of the recent literature. Dermatol Surg. 2012;38(7 Pt 1):971-984. doi:10.1111/j.1524- 4725.2012.02435.x.
Moubasher AE, Youssef EM, Abou-Taleb DA. Q-switched Nd: YAG laser versus trichloroacetic acid peeling in the treatment of melasma among Egyptian patients. Dermatol Surg. 2014;40(8):874-882. doi:10.1097/ DSS.0000000000000065.
Yun WJ, Moon HR, Lee MW, Choi JH, Chang SE. Combination treatment of low-fluence 1,064-nm Q-switched Nd: YAG laser with novel intense pulse light in Korean melasma patients: a prospective, randomized, controlled trial. Dermatol Surg. 2014;40(8):842-850. doi:10.1097/DSS.0000000000000057.
Lee DB, Suh HS, Choi YS. A comparative study of low-fluence 1064-nm Q-switched Nd:YAG laser with or without chemical peeling using Jessner’s solution in melasma patients. J Dermatolog Treat. 2014;25(6):523-528. doi:10.3 109/09546634.2013.848261.
Morais OO, Lemos EF, Sousa MC, Gomes CM, Costa IM, Paula CD. The use of ablative lasers in the treatment of facial melasma. An Bras Dermatol. 2013;88(2):238-242. doi:10.1590/S0365-05962013000200009.
Niwa Massaki AB, Eimpunth S, Fabi SG, Guiha I, Groff W, Fitzpatrick R. Treatment of melasma with the 1,927- nm fractional thulium fiber laser: a retrospective analysis of 20 cases with long-term follow-up. Lasers Surg Med. 2013;45(2):95-101. doi:10.1002/lsm.22100.
Kligman AM, Willis I. A new formula for depigmenting human skin. Arch Dermatol. 1975;111(1):40-48.
Nouri K, Bowes L, Chartier T, Romangosa R, Spencer J. Combination treatment of melasma with pulsed C02 laser followed by Q-switched alexandrite laser: a pilot study. Dermatol Surg. 1999;25:121-123.
Angsuwarangsee S, Polnikorn N. Combined ultrapulse CO2 laser and Q-switched alexandrite laser compared with Q-switched alexandrite laser alone for refractory melasma: split-face design. Dermatol Surg. 2003;29(1):59-64.
Jeong SY, Shin JB, Yeo UC, Kim WS, Kim IH. Low-fluence Q-switched neodymium-doped yttrium aluminum garnet laser for melasma with pre- or post-treatment triple combination cream. Dermatol Surg. 2010;36(6):909-918. doi:10.1111/j.1524-4725.2010.01523.x.
Wattanakrai P, Mornchan R, Eimpunth S. Low-fluence Q-switched neodymium-doped yttrium aluminum garnet (1,064 nm) laser for the treatment of facial melasma in Asians. Dermatol Surg. 2010;36(1):76-87. doi:10.1111/ j.1524-4725.2009.01383.x.
Kroon MW, Wind BS, Beek JF, et al. Nonablative 1550-nm fractional laser therapy versus triple topical therapy for the treatment of melasma: a randomized controlled pilot study. J Am Acad Dermatol. 2011;64(3):516-523. doi:10.1016/j. jaad.2010.01.048.
Wind BS, Kroon MW, Meesters AA, et al. Non-ablative 1,550 nm fractional laser therapy versus triple topical therapy for the treatment of melasma: a randomized controlled split-face study. Lasers Surg Med. 2010;42(7):607-612. doi:10.1002/lsm.20937.
Rajaratnam R, Halpern J, Salim A, Emmett C. Interventions for melasma. Cochrane Database Syst Rev. 2010(7):CD003583. doi:10.1002/14651858.CD003583. pub2.
- Abstract Viewed: 1491 times
- PDF Downloaded: 671 times