Comparison of Picosecond and Nanosecond Nd:YAG 1064-nm Lasers in the Treatment of Melasma: A Split-Face Randomized Clinical Trial.

BACKGROUND

Melasma is a refractory pigmentary disorder. The picosecond Nd:YAG 1064-nm laser (PSNY) has promise as a better treatment for melasma with few side effects and favorable therapeutic efficacy. The authors evaluated the efficacy and safety of PSNY and the nanosecond Q-switched Nd:YAG 1064-nm laser (QSNY) in patients with melasma.

METHODS

Eighteen patients were recruited to receive the two types of laser treatment on split faces. The modified Melasma Area Severity Index was assessed at baseline and the 3-month follow-up visit. The recurrence rate and the patients' self-satisfaction assessment were also evaluated.

RESULTS

The two treated sides showed statistically significant decreases in modified Melasma Area Severity Index score after treatment at follow-up compared with baseline ( P < 0.001). There was no statistically significant difference between the modalities ( P = 0.873) or the patients' satisfaction assessment ( P = 0.287). The visual analogue scale pain assessment score showed that the QSNY was more painful than the PSNY counterpart ( P = 0.007). The recurrence rate was the same for the two treated sides (12.5%).

CONCLUSION

PSNY is a better choice compared with QSNY with less treatment pain and postprocedure erythema as well as lower potential risk of exacerbation of melasma.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.