Split-face Comparison of Pulse-in-pulse Type Intense Pulsed Light Versus Low-fluence Multi-pass 1064 nm Q-switched Nd:YAG Laser in the Treatment of Facial Melasma

Kim, Soo Jin; Lee, Ho Yeol; Park, Hai Jin; Haw, Sik

Abstract

BACKGROUND
Melasma, a common chronic pigmentary disorder, is resistant to various treatments. Recently, pulse-in-pulse type of intense pulsed light (PIP IPL) has been introduced as a treatment for melasma. It can emit multiple peaks during one pulse wave to deliver photothermal energy more effectively with gentle and even low energy so that complications are minimal.
OBJECTIVE
The purpose of this study was to compare the efficacy and safety of PIP IPL to low-fluence, multi-pass, Q-switched Nd:YAG laser in the treatment of facial melasma.
METHODS
Fifteen female patients with melasma who had Fitzpatrick skin type III or IV were enrolled in this study between November 2014 and April 2015. Patients underwent 6 sessions of treatment at an interval of 1 week. One half of each patient's face was treated with 2 passes of PIP IPL with a fluence of 13~15 J/cmâ‚‚. The other half of the face was treated with 4 passes of Q-Switched Nd:YAG laser with a fluence of 1.6~1.8 J/cmâ‚‚. Results were evaluated at every visit, including modified Melasma Area and Severity Index (MASI) score, subject's global assessment, and investigator's global assessment.
RESULTS
Modified MASI scores were significantly (p<0.05) reduced in both groups after 6 treatment sessions. Q-Switched Nd:YAG laser treatment was more effective than PIP IPL for the treatment of melasma, although the two treatments did not significantly (p=0.44) differ in effectiveness. However, the discomfort levels of patients in the PIP IPL group following procedures were significantly lower compared to those in the Q-Switched Nd:YAG group.
CONCLUSION
The current investigation demonstrated that PIP IPL treatment for melasma in Korean women was not inferior to collimated low fluence Q-switched Nd:YAG laser treatment.