Long-term results in low-fluence 1064-nm Q-Switched Nd:YAG laser for melasma: Is it effective?

Objective: This study assessed the safety and clinical efficacy of a low-fluence 1064-nm Q-switched neodymium-doped:yttrium aluminum garnet (QS-Nd:YAG) laser in the treatment of patients with melasma.

Methods: The study evaluated 34 melasma patients treated at a single institution using a 1064-nm QS-Nd:YAG laser. The laser parameters were 6 mm spot size and 2.5 J/cm fluence with multiple passes for 6-10 (median 8) sessions at 2-week intervals. Outcomes were evaluated using photography, the modified Melasma Area and Severity Index (mMASI) score, and patient satisfaction interviews after the last treatment and 1 year after the last treatment.

Results: After the low-fluence 1064-nm QS-Nd:YAG laser treatments, the mean mMASI score decreased from 6.7 ± 3.3 to 3.2 ± 1.6 (P < 0.01). After treatment completion, 20 of 34 patients (58.8%) rated themselves as having at least a 50% reduction in melasma severity. One year after the last treatment, recurrence was observed in 20 patients (58.8%) and the mean mMASI score increased from 3.2 ± 1.6 to 5.8 ± 1.9 in all patients.

Conclusion: The recurrence of low-fluence 1064-nm QS-Nd:YAG laser rates in melasma was high when the long-term results were considered. This result may be attributed to certain patient and treatment-related factors.