Low-dose 1064-nm Q-switched Nd:YAG laser for the treatment of melasma

Background: Melasma is a common acquired pigmentary disorder which is sometimes hard to treat with conventional methods. Various kinds of modalities have been applied for the treatment of melasma but none shows constantly good results. Objectives: In this study, we would like to know the effect of low-dose 1064-nm Q-switched Nd:YAG laser (QSNYL) on melasma and want to evaluate the changes of skin after laser treatment. Methods: Twenty melasma patients were enrolled. Two regions were evaluated from each patient; a total of 40 sites. The 1064-nm QSNYL at fluences of 2.0-3.5 J/cm(2) was used to treat the whole face, including the melasma lesions. The fluence was adjusted individually and increased until erythema was developed on the laser-treated area. The treatment was performed five times with a 1-week interval. Non-invasive measuring methods, including a chromatometer, mexameter, cutometer, visioscan and a corneometer, were used before and after treatment. Results: The L-value from the chromatometer, which reflects the lightness of skin, was increased (0.86 +/- 1.67, p < 0.05). The melanin index from the mexameter was significantly decreased (-28.23 +/- 28.21, p < 0.001). The SEw value from the visioscan, which reflects the degree of wrinkling, decreased (-5.80 +/- 0.59, p = 0.040). None of the other measurement parameters showed significant changes. Conclusions: Low-dose 1064-nm QSNYL appears to be an effective treatment modality for melasma.