Intense Pulsed Light and Low-Fluence Q-Switched Nd:YAG Laser Treatment in Melasma Patients

BACKGROUND: Recently, low fluence collimated Q-switched (QS) Nd:YAG laser has drawn attention for the treatment of melasma. However, it needs a lot of treatment sessions for the substantial results and repetitive laser exposures may end up with unwanted depigmentation. OBJECTIVE: We evaluated the clinical effects and safety of the combinational treatment, using intense pulsed light (IPL) and low fluence QS Nd:YAG laser. METHODS: Retrospective case series of 20 female patients, with mixed type melasma, were analyzed using medical records. They were treated with IPL one time, and 4 times of weekly successive low fluence Nd:YAG laser treatments. At each visit, digital photographs were taken under the same condition. Melanin index (MI) and erythema index (EI) were measured on the highest point on the cheekbones. Modified melasma area and severity index (MASI) scores were calculated by two investigators using digital photographs. RESULTS: The mean values of MI and EI decreased significantly after treatments. The modified MASI score has decreased by 59.35%, on average. Sixty percents of the participants did not require any more treatments, and no clinical aggravations were observed during the follow-up period (mean 5.9 months). CONCLUSION: IPL and low fluence laser may elicit a clinical resolution in the mixed type melasma with long term benefits.