High‐fluence 1064‐nm Q‐Switched Nd:YAG laser: Safe and effective treatment of café‐au‐lait macules in Asian patients

Summary Objectives Café‐au‐lait macules (CALMs) are benign cutaneous hyperpigmentary disorders. Usually, laser therapies for cosmetic concerns result in more severe side effects in the people of Asian descent than that of Caucasians. Unfortunately, there is no gold standard for the laser treatment of CALMs in skin of people of Asian descent. To investigate the efficacy and safety of a high‐fluence 1064‐nm Q‐switched neodymium‐doped yttrium aluminum garnet (Nd:YAG) laser treatment of CALMs in Asian patients. Study design The medical records of 35 Korean patients (age range: 1 to 40 years old, mean age: 18.5 years) diagnosed with isolated CALMs were reviewed retrospectively. Methods The patients were treated with a 1064‐nm Q‐switched Nd:YAG laser. The parameters were a spot size of 7 mm, a fluence of 2.2‐2.4 J/cm2 with a slow single sliding‐stacking pass, and a pulse rate of 10 Hz with a 1‐week interval for 20‐50 sessions. Results At the week of the final treatment, all treated CALMs showed considerable pigmentation removal without any permanent side effects, such as scaring, mottled hypopigmentation and postinflammatory hyperpigmentation (PIH). All treated CALMs showed more than 50% clinical improvement. No recurrence was observed in any of the patients after 12 months of follow‐up. Conclusion A high‐fluence 1064‐nm Q‐switched Nd:YAG laser treatment of CALMs in Asian patients is a safe and effective method without side effects and recurrence.