Dealing with severe or refractory melasma can be challenging for all concerned. A recent study suggests that 1064 nm Nd: YAG laser with a 650-microsecond pulse duration may be a useful laser modality in the treatment of melasma. The study findings were published in the Journal of Cosmetic Dermatology on November 11, 2021.
The effective treatment of melasma remains a challenge that necessitates a multifaceted approach that includes strict sun protection, bleaching creams, chemical peels, and laser therapy. Previous studies findings showed that 1064 nm Nd: YAG laser with a 650-microsecond pulse duration is safe for all skin types and more tolerable than conventional long-pulsed Nd: YAG lasers. To further examine, Dr Tanya Greywal and Dr Arisa Ortiz conducted a study and evaluated the safety and efficacy of 1064 nm Nd: YAG laser with a 650-microsecond pulse duration for the treatment of melasma.
In this conservative treatment protocol, the researchers included a total of 10 patients with the 1064 nm Nd: YAG laser with 650-microsecond pulse duration. They performed treatments every 2–4 weeks. The energy mode ranged from 3 to 4, which corresponds to a fluence of 11to 14J/cm2 with a 6mm spot size, and 3 passes were performed per treatment session.
Key findings of the study:
Upon analysis, the researchers observed lightening of melasma occurred as early as 3 weeks post-treatment, with all subjects requiring several treatment sessions to achieve adequate resolution of their melasma.
They noted that the majority of subjects experienced up to 25% improvement after two treatments, and an even more noticeable improvement after the 3rd treatment session.
They reported no associated pain or discomfort.
The authors concluded, "Advantages of this laser modality include essentially no pain or downtime, lower risk of rebound, and the ability to safely treat all skin types with melasma. Therefore, the 1064 nm Nd: YAG laser with a 650-microsecond pulse duration serves as a treatment option for melasma."
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DOI: https://doi.org/10.1111/jocd.14558