Comparison of low fluence Q-switched alexandrite laser versus Q-switched Nd:Yag laser for the melasma treatment of Asian patients

Takahiro Fujimoto, MD.,Ph.D.  Clinic F, Tokyo, Japan

ASLMS 2009 in Washington DC

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BACKGROUND. : Melasma is common and can cause major psychological impact. To date, the mainstay of treatment, including various hypopigmenting agents and chemical peels, is ineffective and can cause adverse effects. Low fluence Q-switchied Laser treatment is a new approach and is yet to be explored for its efficacy and safety.

OBJECTIVE : To compare low fluence Q-switched alexandrite laser (Accolade, Cynosure, Boston, USA) ( QSAL) with Q-switched Nd:Yag laser (Spectra VRM3, Lutronic inc, Seoul, South Korea)（QSYL）in the treatment of refractory melasma.

METHODS. : Six females- skin types III to IV, age from 20s to 50s were treated with QSAL on one side of the face and QSYL on the other side- with eight laser sessions each at our clinic. Cosmetic skin rejuvenation was accomplished using two wavelengths of 755 nm fluence of 1.6 J/cm2 and 1064 nm fluence of 2.0 J/cm2, a pulse repetition rate of 10Hz. Treatment sites were evaluated comparing with the baseline (pre-treatment) regarding the skin texture, pore size, fine wrinkles, melasma. Transient hypo pigmentation and contact dermatitis were observed in few patients.

Results. :For melasma treatment, there were no difference between QSAL and QSYL but QSAL showed a better result than QSYL in wrinkle reduction.

Conclusion Low fluence QSAL and QSYL are effective for melasma treatment for Asian skin.

Long-term follow-up and a larger number of cases are required to determine its efficacy and safety for refractory melasma.