Melanocyte activation and skin barrier disruption induced in melasma patients after 1064 nm Nd:YAG laser treatment

  • Ya-li Gao
  • Xiao-xiao Jia
  • Min Wang
  • You Hua
  • Han Zheng
  • Wen-zhong Xiang
  • Xiu-zu SongEmail author
Original Article


Melasma is a frequently acquired hyperpigmentary skin disorder, for which several therapies are available. Among them, 1064 nm QS Nd:YAG laser therapy is an effective method, but the recurrence rate of laser treatment is still high. The aim of the present study was to elucidate the mechanism of the high relapse rate of melasma after 1064 nm Nd:YAG laser treatment. Twenty-five female melasma patients were treated with 1064 nm Nd:YAG laser for 10 times. The lesional skin and non-lesional skin were evaluated by means of a reflectance confocal laser scanning microscope before and after laser treatment. Melanin content and transepidermal water loss (TEWL) were measured by an MPA9 skin multifunction tester accordingly. The melanin index value was significantly decreased in the lesional skin after laser treatment, while the non-lesional skin had no difference. The dendritic cells were observed at the level of the dermal-epidermal junction (DEJ) in the lesions of 8 patients before laser treatment, while after laser treatment, the dendritic cells were observed in all 25 subjects. Moreover, there was significant difference between the TEWL value of the lesions before and after laser treatment. Furthermore, the TEWL value was higher in lesions of the 8 subjects which had dendritic cells compared with other 17 subjects which had no dendritic cells, no matter before or after laser treatment. The relapse patients of melasma had higher TEWL value compared with the non-relapse patients. Melanocyte activation and skin barrier disruption may be related to the high relapse rate of melasma after laser treatment.


Melasma Melanocytes Skin barrier 1064 nm Nd:YAG laser 


Funding information

This study was supported by the National Natural Science Foundation of China (No: 81872517), Zhejiang Basic Public Welfare Research Project (No: LGF18H110001), and Hangzhou Science and Technology Bureau Project (No: 20130733Q24).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    JH S, Park YL, Lee JS, Lee SY et al (2014) Treatment of melasma by low-fluence 1064 nm Q-switched Nd:YAG laser. J Dermatolog Treat 25:212–217CrossRefGoogle Scholar
  2. 2.
    Cho SB, Kim JS, Kim MJ (2009) Melasma treatment in Korean women using a 1064-nm Q-switched Nd:YAG laser with low pulse energy. Clin Exp Dermatol 34:e847–e850CrossRefGoogle Scholar
  3. 3.
    Mun JY, Jeong SY, Kim JH, Han SS et al (2011) A low fluence Q-switched Nd:YAG laser modifies the 3D structure of melanocyte and ultrastructure of melanosome by subcellular-selective photothermolysis. J Electron Microsc 60:11–18CrossRefGoogle Scholar
  4. 4.
    Kang HY, Suzuki I, Lee DJ, Ha J et al (2011) Transcriptional profiling shows altered expression of wnt pathway- and lipid metabolism-related genes as well as melanogenesis-related genes in melasma. J Invest Dermatol 131:1692–1700CrossRefGoogle Scholar
  5. 5.
    Man MQ, Lin TK, Santiago JL, Celli A et al (2014) Basis for enhanced barrier function of pigmented skin. J Invest Dermatol 134:2399–2407CrossRefGoogle Scholar
  6. 6.
    Lee AY (2015) Recent progress in melasma pathogenesis. Pigment Cell Melanoma Res 28:648–660CrossRefGoogle Scholar
  7. 7.
    Fabi SG, Friedmann DP, Niwa Massaki AB, Goldman MP (2014) A randomized, split-face clinical trial of low-fluence Q-switched neodymium-doped yttrium aluminum garnet (1,064 nm) laser versus low-fluence Q-switched alexandrite laser (755 nm) for the treatment of facial melasma. Lasers Surg Med 46:531–537CrossRefGoogle Scholar
  8. 8.
    Kang HY, Bahadoran P, Suzuki I, Zugaj D et al (2010) In vivo reflectance confocal microscopy detects pigmentary changes in melasma at a cellular level resolution. Exp Dermatol 19:e228–e233CrossRefGoogle Scholar
  9. 9.
    Xiang W, Song X, Peng J, Xu A et al (2015) Real-time in vivo confocal laser scanning microscopy of melanin-containing cells: a promising diagnostic intervention. Microsc Res Tech 78:1121–1127CrossRefGoogle Scholar
  10. 10.
    Longo C, Pellacani G, Tourlaki A, Galimberti M et al (2014) Melasma and low-energy Q-switched laser: treatment assessment by means of in vivo confocal microscopy. Lasers Med Sci 29:1159–1163CrossRefGoogle Scholar
  11. 11.
    Brown AS, Hussain M, Goldberg DJ (2011) Treatment of melasma with low fluence, large spot size, 1064-nm Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for the treatment of melasma in Fitzpatrick skin types II-IV. J Cosmet Laser Ther 13:280–282CrossRefGoogle Scholar
  12. 12.
    Zhou X, Gold MH, Lu Z, Li Y (2011) Efficacy and safety of Qswitched 1,064-nm neodymium-doped yttrium aluminum garnet laser treatment of melasma. Dermatol Surg 37:962–970CrossRefGoogle Scholar
  13. 13.
    Song HS, Park JY, Kim SJ, Kang HY (2016) In vivo time-sequential histological study focused on melanocytes: suggestion of golden time for intervention to prevent post-laser pigmentary changes. J Eur Acad Dermatol Venereol 30:306–310CrossRefGoogle Scholar
  14. 14.
    Lee DJ, Lee J, Ha J, Park KC et al (2012) Defective barrier function in melasma skin. J Eur Acad Dermatol Venereol 26:1533–1537PubMedGoogle Scholar
  15. 15.
    Chung BY, Noh TK, Yang SH, Kim IH et al (2014) Gene expression profiling in melasma in Korean women. Dermatology 229:333–342CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  • Ya-li Gao
    • 1
  • Xiao-xiao Jia
    • 1
  • Min Wang
    • 1
  • You Hua
    • 1
  • Han Zheng
    • 1
  • Wen-zhong Xiang
    • 1
  • Xiu-zu Song
    • 1
    Email author
  1. 1.Department of Dermatology, Affiliated Third Hospital of HangzhouAnhui Medical UniversityHangzhouChina

Personalised recommendations