Ann Dermatol.  2016 Jun;28(3):290-296. 10.5021/ad.2016.28.3.290.

Treatment of Melasma with the Photoacoustic Twin Pulse Mode of Low-Fluence 1,064 nm Q-Switched Nd:YAG Laser

• Kim JY
• Choi M
• Nam CH
• Kim JS
• Kim MH
• Park BC
• Hong SP

• KMID: 2164635
• DOI: http://doi.org/10.5021/ad.2016.28.3.290

Abstract

BACKGROUND
Low-fluence 1,064 nm Q-switched Nd:YAG laser has been widely used for the treatment of melasma. Although new Q-switched Nd:YAG lasers with photoacoustic twin pulse (PTP) mode have been recently developed for high-efficiency, there is limited information available for the new technique.
OBJECTIVE
This study was designed to investigate the efficacy and adverse effects after few sessions of repeated low fluence 1,064 nm Q-switched Nd:YAG laser treatment with PTP mode in Asian women with melasma.
METHODS
Twenty-two Korean women were treated with a total of five sessions of low-fluence PTP mode Nd:YAG laser treatment (Pastelle®) at 2 weeks interval. Responses to treatments were evaluated by using Melasma Area and Severity Index (MASI) scoring, colorimeter measurement, and the investigators' and patients' overall assessments. Adverse events were recorded at each visit.
RESULTS
Investigators' and patients' overall assessment showed that 'significantly improved' was assessed by 13 (59.1%) and 19 of 22 patients (86.4%), respectively. MASI scores were significantly reduced by 20.4%. The lightness, measured by using a colorimeter, was significantly increased by 1.3 point. Notable adverse events were not observed.
CONCLUSION
After 5 sessions of laser therapy alone, about 60% of the subjects showed significant improvement. Few sessions of repeated laser toning treatment using the PTP mode is a safe and effective way to treat facial melasma.

Keyword

Laser toning; Melasma; Nd:YAG laser; Photoacoustic twin pulse

MeSH Terms

Asian Continental Ancestry Group
Female
Humans
Laser Therapy
Melanosis*
Twins*

Figure

• 

  Fig. 1 Changes of (A) Melasma Area and Severity Index (MASI) score and (B) skin brightness with 5 sessions of photoacoustic twin pulse mode laser toning. L* values were measured by colorimeter. *p<0.05, **p<0.01.

• 

  Fig. 2 A 40-year-old female with phototype III skin. (A) Before treatment (MASI=10.1), (B) two weeks after completion of five treatments showing about 60% improvement of melasma (MASI=4.4). Note the improvement of left cheek after treatment. MASI: Melasma Area and Severity Index.

• 

  Fig. 3 Global assessments evaluated by (A) investigators and (B) patients.

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  Fig. 4 Adverse effects of photoacoustic twin pulse mode laser toning treatments. (A) Overall, (B) erythema grade, (C) pain score.

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