ABSTRACT
Objective To observe the effect of non-ablative treatment combined intense pulse light (IPL) and Q switched Nd :YAG laser on hyperpigmented skin diseases. Methods Total 250 cases of Fitzpatrick skin types Ⅲ and Ⅳ with hyperpigmented skin disorders received 4 treatments with combined 560nm IPI. and 532 nm Q switched Nd :YAG laser. The interval between two treat-ments was I month. After 3 months the effect of IPL was observed. If it was not good, we used the Q switched Nd :YAG laser. Efficacy and adverse effects were evaluated 3-6 months after the final treat-ment. Results 3-6 months after the last treatment, 50%-70% of patients had their telangiectasia, enlarged pores, hyperpigmentation and wrinking of facial photoaging improved. The degree of im-provement was more than 60 %. Common side effects were minor blistering and erythema. Conclusion Combined IPI. and Q switched Nd :YAG laser treatment is an idea non-ablative therapy for telangi-ectasia, enlarged pores, hyperpigmentation and wrinking of facial photoaging in Fitzpatrick skin types Ⅲ and Ⅳ in Asian.
ABSTRACT
BACKGROUND: Laser treatment in melasma has previously failed because of the resulting inflammation and consequent pigmentation and excessive thermal damage caused by the use of high fluence. OBJECTIVE: This study is aimed at establishing the concept of the collimated low fluence Q-switched Nd : YAG laser as a treatment for melasma by investigating its therapeutic effects clinically as well as histopathologically. METHODS: 27 patients were treated weekly with Q-switched Nd : YAG laser (1,064 nm wavelength, 7 mm spot size, 1.6~2.5 J/cm2 fluence) for 8 weeks. The results were evaluated based on standardized clinical images that used Robo skin analyzer, spectrophotometer, MASI score and general severity. RESULTS: 17 (58.8%) patients showed "GOOD" (50~75% improvement) and no case of full recurrence was examined and partial recurrence was detected in 12/17 patients. Common adverse effects include pain, erythema, and temporary edema. Rarely partial hypopigmented macules and diffuse hyperpigmentation appeared. Additional studies, such as immunohistochemical examination and electron microscopic examination, are also currently in progress. CONCLUSION: The collimated low fluence Q-switched Nd : YAG Laser is effective in melasma treatment. This treatment method is a new concept that can be described as selective photothermolysis with minimal thermal damage and inflammation reaction to affected tissues by pigmentation. We consider this treatment method should be regarded as Minimized Selective Photothermolysis (MSP) that will provide a new effective treatment for melasma.