Split-face Comparison of Pulse-in-pulse Type Intense Pulsed Light Versus Low-fluence Multi-pass 1064 nm Q-switched Nd:YAG Laser in the Treatment of Facial Melasma / 대한피부과학회지

ABSTRACT

BACKGROUND: Melasma, a common chronic pigmentary disorder, is resistant to various treatments. Recently, pulse-in-pulse type of intense pulsed light (PIP IPL) has been introduced as a treatment for melasma. It can emit multiple peaks during one pulse wave to deliver photothermal energy more effectively with gentle and even low energy so that complications are minimal. OBJECTIVE: The purpose of this study was to compare the efficacy and safety of PIP IPL to low-fluence, multi-pass, Q-switched NdYAG laser in the treatment of facial melasma. METHODS: Fifteen female patients with melasma who had Fitzpatrick skin type III or IV were enrolled in this study between November 2014 and April 2015. Patients underwent 6 sessions of treatment at an interval of 1 week. One half of each patient's face was treated with 2 passes of PIP IPL with a fluence of 13~15 J/cm₂. The other half of the face was treated with 4 passes of Q-Switched NdYAG laser with a fluence of 1.6~1.8 J/cm₂. Results were evaluated at every visit, including modified Melasma Area and Severity Index (MASI) score, subject's global assessment, and investigator's global assessment. RESULTS: Modified MASI scores were significantly (p<0.05) reduced in both groups after 6 treatment sessions. Q-Switched NdYAG laser treatment was more effective than PIP IPL for the treatment of melasma, although the two treatments did not significantly (p=0.44) differ in effectiveness. However, the discomfort levels of patients in the PIP IPL group following procedures were significantly lower compared to those in the Q-Switched NdYAG group. CONCLUSION: The current investigation demonstrated that PIP IPL treatment for melasma in Korean women was not inferior to collimated low fluence Q-switched NdYAG laser treatment.