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

Summary 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/cm2 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.