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Low-Power Fractional CO2 Laser Versus Low-Fluence Q-Switch 1,064 nm Nd:YAG Laser for Treatment of Melasma: A Randomized, Controlled, Split-Face Study

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Abstract

Background

Various laser treatments are currently available for melasma but their use remains challenging because of potential side effects.

Objective

The aim of this randomized controlled study was to compare the efficacy and safety of low-fluence Q-switch 1,064 nm Nd:YAG and low-power fractional CO2 laser using a split-face design.

Materials and Methods

A total of 40 female patients with symmetric melasma were enrolled to the study and each side of their face was randomly allocated to either low-fluence Q-switch 1,064 nm Nd:YAG or low-power fractional CO2 laser. They were treated every 3 weeks for five consecutive sessions and followed for 2 months after the last treatment session. Response to treatment was assessed using the Melanin Index (MI) score, modified Melasma Area and Severity Index (mMASI) score, and a subjective self-assessment method.

Results

At the 2-month follow-up visit, both sides of the face had statistically significant reductions in the MI and mMASI scores compared with the first visit (p < 0.001). The differences between the mean MI and mMASI scores at baseline and at 2-month follow-up were compared between the two treatments and results showed that the reduction of MI and mMASI score in the fractional CO2 laser-treated side was significantly more than on the Q-switch 1,064 nm Nd:YAG laser-treated side (p < 0.001). There were no significant adverse effects with either of the laser treatments.

Conclusion

The present study shows that low-power fractional CO2 laser is safe and effective and can be considered as a valuable approach in the treatment of melasma.

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Acknowledgments

No sources of funding were used to conduct this study or prepare this manuscript. N.Y. Jalaly, N. Valizadeh, B. Barikbin, and M. Yousefi have no conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tajrish Sq, PO Box 1989934148, Tehran, Iran

    Niloofar Y. Jalaly, Neda Valizadeh & Behrooz Barikbin

  2. Skin Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Maryam Yousefi

Authors
  1. Niloofar Y. Jalaly
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  2. Neda Valizadeh
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  3. Behrooz Barikbin
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  4. Maryam Yousefi
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Corresponding author

Correspondence to Behrooz Barikbin.

Additional information

Clinical Trial Registration Number: IRCT.IR identifier: IRCT201201318146N2.

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Jalaly, N.Y., Valizadeh, N., Barikbin, B. et al. Low-Power Fractional CO2 Laser Versus Low-Fluence Q-Switch 1,064 nm Nd:YAG Laser for Treatment of Melasma: A Randomized, Controlled, Split-Face Study. Am J Clin Dermatol 15, 357–363 (2014). https://doi.org/10.1007/s40257-014-0080-x

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