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Laser therapy in the treatment of melasma: a systematic review and meta-analysis

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Abstract

Melasma is a highly prevalent and cosmetically disfiguring pigmented skin disease. The post-treatment results are often unsatisfactory. A large number of clinical trials have tried to prove the effectiveness of the combination therapy involving laser therapy, but the results have been indeterminate. This study aimed to evaluate the effectiveness of laser treatment for melasma via a systematic review and meta-analysis. We respectively searched 4 databases and clinicaltrials.gov as of June 8, 2021. Two researchers independently searched for literature and extracted data. Study outcomes were computed by weighted mean differences (WMD). All statistical analyses were performed by the Review Manager version 5.3, STATA version 14 software at 95% confidence interval. We obtained 22 eligible studies which involved a total of 694 patients. After the heterogeneity test and sensitivity analysis, we took a subgroup meta-analysis on the before and after treatment of different laser types. We found that most lasers and laser-based combinations were associated with reduced melasma area and severity index (MASI), such as low-fluence Q-switch 1,064-nm Nd: YAG laser (QSNYL) (WMD: − 2.76; 95% CI: − 3.53 to − 1.99), fractional ablative CO2 laser (WMD: − 9.36; 95% CI: − 12.51 to − 6.21), and fractional ablative 2940-nm Er: YAG laser (WMD: − 2,72; 95% CI: − 3.94 to − 1.49). Significant decrease was seen in neither MASI score of non-ablative 1550-nm fractional laser (WMD: − 1.29; 95% CI: − 2.80 to 0.21) and picosecond laser (WMD: − 0.58; 95% CI: − 1.43 to 0.27), nor melanin index (MI) of low-fluence QSNYL treatment (WMD: 10.17; 95% CI: − 4.11 to 24.46). When using laser to treat melasma, various adverse reactions may occur, most of which will resolve quickly without subsequent treatment, such as edema, erythema, scaling, and burning sensation after treatment. However, for patients with darker skin, there are risks of postinflammatory hyperpigmentation and hypopigmentation. The laser and laser-based combination treatment for melasma could significantly reduce the MASI score, which was showed by our systematic review and meta-analysis.

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Data availability

The data supporting the findings of this study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to express our sincere gratitude to the Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, for help in revising the critical content of the manuscript.

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Authors and Affiliations

  1. Department of Dermatology, Beijing ChuiYangLiu Hospital, Beijing, China

    Dihui Lai, Shaona Zhou & Shaowei Cheng

  2. Department of Dermatology, MEIYAN Aesthetic Plastic Medical Clinic, Beijing, China

    Hongmei Liu

  3. Department of Dermatology, China-Japan Friendship Hospital, NO.2 Yinghua East Road, Chaoyang District, Beijing, China

    Yong Cui

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  1. Dihui Lai
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  4. Hongmei Liu
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Contributions

All authors contributed to the study conception and design. Dihui Lai and Shaona Zhou were responsible for the material preparation, data collection, and analysis. The first draft of the manuscript was written by Dihui Lai. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Yong Cui.

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Lai, D., Zhou, S., Cheng, S. et al. Laser therapy in the treatment of melasma: a systematic review and meta-analysis. Lasers Med Sci 37, 2099–2110 (2022). https://doi.org/10.1007/s10103-022-03514-2

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  • DOI: https://doi.org/10.1007/s10103-022-03514-2

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