A prospective randomized comparative study on 60 Indian patients of melasma, comparing pixel Q-switched NdYAG (1064 nm), super skin rejuvenation (540 nm) and ablative pixel erbium YAG (2940 nm) lasers, with a review of the literature

References

• Handel AC, Miot LDB, Miot HA. Melasma: a clinical and epidemiological review. An Bras Dermatol. 2014 Oct; 89(5): 771–82. doi:10.1590/abd1806-4841.20143063.
   PubMed Web of Science ®Google Scholar
• Pawaskar MD, Parikh P, Markowski T, McMichael AJ, Feldman SR, Balkrishnan R. Melasma and its impact on health-related quality of life in hispanic women. J Dermatol Treat. 2007;18(1):5–9. doi:10.1080/09546630601028778.
   PubMed Web of Science ®Google Scholar
• Sonthalia S, Sarkar R. Etiopathogenesis of melasma. Pigm Int. 2015;2:21–27. doi:10.4103/2349-5847.159389.
   Google Scholar
• Halachmi S, Haedersdal M, Lapidoth M. Melasma and laser treatment: an evidenced-based analysis. Lasers Med Sci. 2014 Mar; 29(2): 589–98. doi:10.1007/s10103-013-1318-1.
   PubMed Web of Science ®Google Scholar
• Trivedi MK, Yang FC, Cho BK. A review of laser and light therapy in melasma. Int J Womens Dermatol. 2017 Mar; 3(1): 11–20. doi:10.1016/j.ijwd.2017.01.004.
   PubMedGoogle Scholar
• Behrangi E, Baniasadi F, Esmaeeli S, Hedayat K, Goodarzi A, Azizian Z. Serum iron level, ferritin and total iron binding capacity level among nonpregnant women with and without melasma. J Res Med Sci. 2015 Mar;20(3):281–83.
   PubMed Web of Science ®Google Scholar
• Kimbrough-Green CK, Griffiths CE, Finkel LJ, Hamilton TA, Bulengo-Ransby SM, Ellis CN, Voorhees JJ. Topical retinoic acid (tretinoin) for melasma in black patients. A vehicle-controlled clinical trial. Arch Dermatol. 1994 Jun;130(6):727–33. doi:10.1001/archderm.1994.01690060057005.
   PubMedGoogle Scholar
• Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science. 1983 Apr 29;220(4596):524–27. doi:10.1126/science.6836297.
   PubMed Web of Science ®Google Scholar
• Arora P, Sarkar R, Garg VK, Arya L. Lasers for treatment of melasma and post-inflammatory hyperpigmentation. J Cutan Aesthetic Surg. 2012;5(2):93–103. doi:10.4103/0974-2077.99436.
   PubMedGoogle Scholar
• Anderson RR, Margolis RJ, Watenabe S, Flotte T, Hruza GJ, Dover JS. Selective photothermolysis of cutaneous pigmentation by Q-switched Nd: YAG laser pulses at 1064, 532, and 355 nm. J Invest Dermatol. 1989 Jul; 93(1): 28–32. doi:10.1111/1523-1747.ep12277339.
   PubMed Web of Science ®Google Scholar
• Suh KS, Sung JY, Roh HJ, Jeon YS, Kim YC, Kim ST. Efficacy of the 1064-nm Q-switched Nd: YAG laser in melasma. J Dermatol Treat. 2011 Aug; 22(4): 233–38. doi:10.3109/09546631003686051.
   PubMed Web of Science ®Google Scholar
• Mun JY, Jeong SY, Kim JH, Han SS, Kim I-H. A low fluence Q-switched Nd: YAG laser modifies the 3D structure of melanocyte and ultrastructure of melanosome by subcellular-selective photothermolysis. J Electron Microsc (Tokyo). 2011;60(1):11–18. doi:10.1093/jmicro/dfq068.
   PubMedGoogle Scholar
• Kim EH, Kim YC, Lee E-S, Kang HY. The vascular characteristics of melasma. J Dermatol Sci. 2007 May; 46(2): 111–16. doi:10.1016/j.jdermsci.2007.01.009.
   PubMed Web of Science ®Google Scholar
• Wattanakrai P, Mornchan R, Eimpunth S. Low-fluence Q-switched neodymium-doped yttrium aluminum garnet (1,064 nm) laser for the treatment of facial melasma in Asians. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2010;36(1):76–87.
   PubMed Web of Science ®Google Scholar
• Cho SB, Kim JS, Kim MJ. Melasma treatment in Korean women using a 1064-nm Q-switched Nd: YAG laser with low pulse energy. Clin Exp Dermatol. 2009 Dec; 34(8): e847–850. doi:10.1111/j.1365-2230.2009.03599.x.
   PubMed Web of Science ®Google Scholar
• Kar HK, Gupta L, Chauhan A. A comparative study on efficacy of high and low fluence Q-switched Nd: YAG laser and glycolic acid peel in melasma. Indian J Dermatol Venereol Leprol. 2012 Mar 1;78(2):165. doi:10.4103/0378-6323.93633.
   PubMed Web of Science ®Google Scholar
• Yue B, Yang Q, Xu J, Lu Z. Efficacy and safety of fractional Q-switched 1064-nm neodymium-doped yttrium aluminum garnet laser in the treatment of melasma in Chinese patients. Lasers Med Sci. 2016 Nov; 31(8): 1657–63. doi:10.1007/s10103-016-2034-4.
   PubMed Web of Science ®Google Scholar
• Gokalp H, Akkaya AD, Oram Y. Long-term results in low-fluence 1064-nm Q-switched Nd: YAG laser for melasma: is it effective? J Cosmet Dermatol. 2016 Dec; 15(4): 420–26. doi:10.1111/jocd.2016.15.issue-4.
   PubMed Web of Science ®Google Scholar
• Hofbauer Parra CA, Careta MF, Valente NYS, de Sanches Osório NEG, Torezan LAR. Clinical and histopathologic assessment of facial melasma after low-fluence Q-switched neodymium-doped yttrium aluminium garnet laser. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2016 Apr;42(4):507–12.
   PubMed Web of Science ®Google Scholar
• Jang YH, Park J-Y, Park YJ, Kang HY. Changes in melanin and melanocytes in mottled hypopigmentation after low-fluence 1,064-nm Q-switched Nd: YAG laser treatment for melasma. Ann Dermatol. 2015 Jun; 27(3): 340–42. doi:10.5021/ad.2015.27.3.340.
   PubMed Web of Science ®Google Scholar
• Wong Y, Lee SSJ, Goh CL. Hypopigmentation induced by frequent low-fluence, large-spot-size QS Nd: YAG Laser treatments. Ann Dermatol. 2015 Dec; 27(6): 751–55. doi:10.5021/ad.2015.27.6.751.
   PubMed Web of Science ®Google Scholar
• Chan NPY, Ho SGY, Shek SYN, Yeung CK, Chan HH. A case series of facial depigmentation associated with low fluence Q-switched 1,064 nm Nd: YAG laser for skin rejuvenation and melasma. Lasers Surg Med. 2010 Oct; 42(8): 712–19. doi:10.1002/lsm.20956.
   PubMed Web of Science ®Google Scholar
• Kim MJ, Kim JS, Cho SB. Punctate leucoderma after melasma treatment using 1064-nm Q-switched Nd: YAG laser with low pulse energy. J Eur Acad Dermatol Venereol JEADV. 2009 Aug; 23(8): 960–62. doi:10.1111/j.1468-3083.2008.03070.x.
   PubMed Web of Science ®Google Scholar
• Tian B. The Asian problem of frequent laser toning for melasma : JCAD | the journal of clinical and aesthetic dermatology. J Clin Aesthet Dermatol. 2017;10(7):40–42.
   PubMedGoogle Scholar
• Tanaka Y, Matsuo K, Yuzuriha S. Objective assessment of skin rejuvenation using near-infrared 1064-nm neodymium: YAG laser in Asians. Clin Cosmet Investig Dermatol. 2011 Jul 27;4:123–30. doi:10.2147/CCID.S22841.
   PubMedGoogle Scholar
• Lee M-WC. Combination 532-nm and 1064-nm lasers for noninvasive skin rejuvenation and toning. Arch Dermatol. 2003 Oct;139(10):1265–76.
   PubMedGoogle Scholar
• Xi Z, Gold MH, Zhong L, Efficacy YL. Safety of Q-switched 1,064-nm neodymium-doped yttrium aluminum garnet laser treatment of melasma. Dermatol Surg. 2011 Jul 1;37(7):962–70. doi:10.1111/j.1524-4725.2011.02001.x.
   PubMed Web of Science ®Google Scholar
• Wang -C-C, Hui C-Y, Sue Y-M, Wong W-R, Hong H-S. Intense pulsed light for the treatment of refractory melasma in Asian persons. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2004 Sep;30(9):1196–200.
   PubMed Web of Science ®Google Scholar
• Weiss RA, Weiss MA, Beasley KL. Rejuvenation of photoaged skin: 5 years results with intense pulsed light of the face, neck, and chest. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2002 Dec;28(12):1115–19.
   PubMed Web of Science ®Google Scholar
• Goldberg DJ. Current trends in intense pulsed light. J Clin Aesthetic Dermatol. 2012 Jun;5(6):45–53.
   PubMedGoogle Scholar
• Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med. 2004;34(5):426–38. doi:10.1002/lsm.20045.
   PubMed Web of Science ®Google Scholar
• Naito SK. Fractional photothermolysis treatment for resistant melasma in Chinese females. J Cosmet Laser Ther Off Publ Eur Soc Laser Dermatol. 2007 9;Sep(3):161–63. doi: 10.1080/14764170701418814.
   Google Scholar
• Tourlaki A, Galimberti MG, Pellacani G, Bencini PL. Combination of fractional erbium-glass laser and topical therapy in melasma resistant to triple-combination cream. J Dermatol Treat. 2014 Jun; 25(3): 218–22. doi:10.3109/09546634.2012.671911.
   PubMed Web of Science ®Google Scholar
• Goldberg DJ, Berlin AL, Phelps R. Histologic and ultrastructural analysis of melasma after fractional resurfacing. Lasers Surg Med. 2008 Feb; 40(2): 134–38. doi:10.1002/lsm.20678.
   PubMed Web of Science ®Google Scholar
• Rokhsar CK, Fitzpatrick RE. The treatment of melasma with fractional photothermolysis: a pilot study. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2005 Dec;31(12):1645–50.
   PubMed Web of Science ®Google Scholar
• Sardesai VR, Kolte JN, Srinivas BN. A clinical study of melasma and a comparison of the therapeutic effect of certain currently available topical modalities for its treatment. Indian J Dermatol. 2013;58(3):239. doi:10.4103/0019-5154.110842.
   PubMedGoogle Scholar
• Bansal C, Naik H, Kar HK, Chauhan A. A comparison of low-fluence 1064-nm Q-switched Nd: YAG laser with topical 20% azelaic acid cream and their combination in melasma in Indian patients. J Cutan Aesthetic Surg. 2012;5(4):266–72. doi:10.4103/0974-2077.104915.
   PubMedGoogle Scholar
• Park KY, Kim DH, Kim HK, Li K, Seo SJ, Hong CK. A randomized, observer-blinded, comparison of combined 1064-nm Q-switched neodymium-doped yttrium-aluminium-garnet laser plus 30% glycolic acid peel vs. laser monotherapy to treat melasma. Clin Exp Dermatol. 2011 Dec; 36(8): 864–70. doi:10.1111/j.1365-2230.2011.04150.x.
   PubMed Web of Science ®Google Scholar
• Lee DB, Suh HS, Choi YS. A comparative study of low-fluence1064-nm Q-switched Nd: YAG laser with or without chemical peeling using Jessner’s solution in melasma patients. J Dermatol Treat. 2014;25(6):523–28. doi:10.3109/09546634.2013.848261.
   PubMed Web of Science ®Google Scholar
• Goldman MP, Gold MH, Palm MD, Colón LE, Preston N, Johnson LA, Gottschalk RW. Sequential treatment with triple combination cream and intense pulsed light is more efficacious than sequential treatment with an inactive (control) cream and intense pulsed light in patients with moderate to severe melasma. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2011 Feb;37(2):224–33.
   PubMed Web of Science ®Google Scholar
• Trelles MA, Velez M, Gold MH. The treatment of melasma with topical creams alone, CO2 fractional ablative resurfacing alone, or a combination of the two: a comparative study. J Drugs Dermatol JDD. 2010 Apr;9(4):315–22.
   PubMed Web of Science ®Google Scholar
• Omi T, Yamashita R, Kawana S, Sato S, Naito Z. Low fluence Q-switched Nd: YAG laser toning and Q-switched ruby laser in the treatment of melasma: acomparative split-face ultrastructural study. Laser Ther. 2012 Mar 28;21(1):15–21. doi:10.5978/islsm.12-OR-03.
   PubMedGoogle Scholar
• Angsuwarangsee S, Polnikorn N. Combined ultrapulse CO2 laser and Q-switched alexandrite laser compared with Q-switched alexandrite laser alone for refractory melasma: split-face design. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2003 Jan;29(1):59–64.
   PubMed Web of Science ®Google Scholar
• Nouri K, Bowes L, Chartier T, Romagosa R, Spencer J. Combination treatment of melasma with pulsed CO2 laser followed by Q-switched alexandrite laser: a pilot study. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 1999 Jun;25(6):494–97.
   PubMed Web of Science ®Google Scholar
• Na SY, Cho S, Lee JH. Intense pulsed light and low-fluence Q-switched Nd: YAG Laser treatment in melasma patients. Ann Dermatol. 2012 Aug; 24(3): 267–73. doi:10.5021/ad.2012.24.3.267.
   PubMed Web of Science ®Google Scholar
• Tian WCBA. Novel technique to treat melasma in Chinese: the combination of 2940-nm fractional Er: yAGand 1064-nm Q-switched Nd: YAG laser. J Cosmet Laser Ther Off Publ Eur Soc Laser Dermatol. 2016;18(2):72–74. doi:10.3109/14764172.2015.1063662.
   PubMed Web of Science ®Google Scholar
• Sardana K, Chugh S, Garg VK. Which therapy works for melasma in pigmented skin: lasers, peels, or triple combination creams? Indian J Dermatol Venereol Leprol. 2013 May 1;79(3):420. doi:10.4103/0378-6323.110771.
   PubMed Web of Science ®Google Scholar