Assessing efficacy of energy-based devices in melasma: Q-switched Nd-YAG laser vs. Intense Pulsed Light
Keywords:
Melasma, Q-Switched Nd, YAG laser 1064nm, Intense Pulsed LightAbstract
Background Melasma is a common problem affecting many young females. Energy based devices are now used to treat melasma but there is fear of post-inflammatory hypo or hyperpigmentation, especially in Asian population. There is need to evaluate efficacy and safety of these devices in our population and find out what suits best in Asian skin. There is no study in the literature to the best of our knowledge which made comparison of Q switched Nd:YAG 1064nm laser and Intense Pulsed Light for treatment of melasma. Objective To compare efficacy of Q-switched Nd:YAG 1,064nm laser and Intense Pulsed Light in the treatment of melasma in Asian females. Methods A total of 60 patients (30 in each group) were included in this study. Group-A was treated with Q switched Nd:YAG 1064nm laser and group-B was treated with Intense Pulsed Light. 4 sessions 3 weekly were given to patients either of IPL or Q switch laser and efficacy was measured by mMASI score one week after completion of four sessions of treatment. All the collected data was entered and analyzed through SPSS version 21. Results Mean age of the patients was 31.4±4.4 years (group-A) and 34.2±5.4 years (group-B). Mean baseline mMASI score was 7.3±3.4 and 6.4±2.9 in group A and B, respectively (p=0.335); while post treatment mMASI score was 3.6±2.1 in group A and 2.7±1.6 in group B (p=0.074). No side effects or long term complications were noted. Treatment was effective in 60% of patients in group A while in 80% patients in group B. Difference between two groups was statistically insignificant (p=0.091). Conclusion 1064-nm QS Nd: YAG laser and Intense Pulsed Light both were equally effective (p=0.09) and safe for the treatment of melasma.References
Kyoun SH, Park KC. Melasma and Common Pigmentary Dermatoses in Asian Individuals and an Overview of their Treatment. J Clin Investigat Dermatol 2014; 2(1): 8.
Handel AC, Miot LDB, and Miot HA. Melasma: a clinical and epidemiological review. An Bras Dermatol 2014; 89(5): 771–782.
Kwon SH, Hwang YJ, Lee SK, et al. Heterogeneous pathology of melasma and its clinical implications. Int J Mol Sci 2016; 17(6): 824.
Trivedi MK, Yang FC, and Cho BK. A review of laser and light therapy in melasma. Int J Womens Dermatol 2017; 3(1): 11–20.
Sim JH, Park YL, Lee IS, Lee SY, et al. Treatment of Melasma by Low-fluence 1064 nm Q-Switch Nd:YAG Laser. J Dermatolog Treat 2014; 25: 212-7.
Zhou X, Gold MH, Lu Z, et al. Efficacy and Safety of Q-Switched 1,064nm Neodymium-Doped Yttrium Aluminum Garnet Laser Treatment of Melasma. Dermatol Surg 2011; 37: 962-70.
Zoccali G, Piccolo D, Allegra P, et al. Melasma Treated with Intense Pulsed Light. Aesth Plast Surg 2010; 34: 486-93.
Rodrigues M, Ayala-Cortés AS, Rodríguez-Arámbula A, Hynan LS, Pandya AG. Interpretability of the Modified Melasma Area and Severity Index (mMASI). JAMA Dermatol 2016; 152(9):1051–1052.
Krupa-Shankar DSR, Somani VK, Kohli M, et al. A Cross-Sectional, Multicentric Clinico-Epidemiological Study of Melasma in India. Dermatol Ther 2014; 4(1): 71–81.
Longo C, Pellacani G, Tou Dermatol, et al. Melasma and low-energy Q-switched laser: treatment assessment by means of in vivo confocal microscopy. Lasers Med Sci 2014; 29(3): 1159-63.
Na SY, Cho S, Lee J H. Intense Pulsed Light and low fluence Q-switched Nd:YAG Laser Treatment in melisma patients. Ann Dermatol 2012; 24(3): 267-273.
Hammam MA, Alsalam A, Tabana ES. The role of laser and intense pulse light in the treatment of hyperpigmentation disorders. Menoufia Med J. 2016; 29: 17-21.
Polnikorn N. New Approach for Laser Treatment of Melasma and Hyperpigmented Lesions. Pigmentary Disorders. 2014; 1: 128.
C. Wang, CY, Hui, YM, Sue, WR, et al. Intense pulsed light for the treatment of refractory melasma in Asian persons. Dermatol Surg. 2004; 30: 1196-1200.
Shakeeb N, Noor SM, Ghafoor Ullah et al. Efficacy of intense pulse light therapy and triple combination cream versus intense pulse light therapy and triple combination cream alone in epidermal melasma treatment. J Coll Physicians Surg Pak 2018; 28(1): 13-16.
Wajeiha S, Altaf F, Khurshid K, et al. Efficacy of intense pulsed light in melasma. J Pak Assoc Derma 2014; 24(3): 212-216.
Qazi I, Dogra NK, and Dogra D. Research Article Serum Iron profile in Female patients of Melasma: A case control study. Asian Pac. J Health Sci 2017; 4(2): 141-146.