Effects of a fractional picosecond 1,064 nm laser for the treatment of dermal and mixed type melasma.

BACKGROUND

Picosecond laser is a novel modality for pigmented skin disorders with extremely short pulse duration. Little is known about the effects of the picosecond laser in melasma.

OBJECTIVE

This study aimed to investigate the efficacy of fractional picosecond 1,064 nm laser in melasma treatment.

STUDY

DESIGN

A prospective, randomized, assessor-blinded, intra-individual split face comparative study.

METHODS

Female subjects with melasma were enrolled and received fractional picosecond 1,064 nm laser plus 4% hydroquinone cream on one randomly assigned side of the face; the results were compared to the use of hydroquinone cream only on the contralateral side. The modified melasma area severity index (mMASI) score, melanin index by Mexameter MX18®, participant satisfaction score by quartile rating scale, and the quality of life by the dermatology life quality index (DLQI) were evaluated over 12 weeks.

RESULTS

Thirty female subjects completed the protocol. The mean (± standard deviation, SD) mMASI score at the 12-week visit was significantly reduced in the picosecond laser-treated areas compared to controls (3.52 ± 1.4 and 4.18 ± 2.03 respectively; p = 0.035). No differences were observed in the mean Mexameter melanin index, participant satisfaction score, and DLQI score. The observed adverse effects included transient mild erythema and mild skin desquamation.

CONCLUSION

The addition of fractional picosecond 1,064 nm laser to 4% hydroquinone was effective and significantly better than 4% hydroquinone alone for the treatment of melasma.