Med Lasers.  2022 Sep;11(3):159-165. 10.25289/ML.2022.11.3.159.

Treatment of melasma using a combination of CO² laser and Q-switched ruby laser

• Park JD
• Kim SY
• Jeong HG
• Wee SY

• KMID: 2533592
• DOI: http://doi.org/10.25289/ML.2022.11.3.159

Abstract

Background and Objectives
The CO² laser is a tissue-selective laser that removes superficial lesions by vaporization and ablation. The Q-switched ruby laser (QSRL) is a pigment-selective laser that induces the disruption of melanosomes. This study aimed to evaluate the effects of a combination treatment of the CO² laser and QSRL on melasma.
Materials and Methods
Fifteen patients with melasma were initially treated with a CO² laser, followed by multiple QSRL toning. Photographs were taken on the first visit, on completion of the prescribed regimen, and 6 months after the treatment. The melasma area and severity index (MASI) and melasma severity scale (MSS) were evaluated through clinical photographs. Patients subjectively evaluated their improvement on a 5-point scale.
Results
There was a significant change in both mean MASI and MSS scores after the combination treatment with the CO² laser and QSRL. The MASI score decreased from 5.82 ± 2.6393 to 2.607 ± 1.6973 (p = 0.001). The MSS score significantly decreased from 2.67 ± 0.488 to 1.20 ± 0.561 (p < 0.001). There were no statistically significant differences in the MASI (p = 0.891) and MSS scores (p = 0.046) between post-procedure and 6-month follow-up.
Conclusion
The combination of a CO² laser and QSRL appears to be effective in the treatment of melasma.

Keyword

Melasma; Lasers