Treatment of melasma using variable square pulse Er:YAG laser resurfacing

Area of Science:

• Dermatology
• Aesthetic Medicine
• Laser Technology

Background:

• Melasma treatment presents significant challenges, with conventional laser therapies often yielding limited efficacy and high recurrence rates.
• Variable-pulsed erbium:yttrium aluminum garnet (Er:YAG) lasers are emerging as a promising option for skin resurfacing due to their favorable outcomes and reduced side effects.

Purpose of the Study:

• To evaluate the effectiveness and safety of variable square pulsed (VSP) Er:YAG laser resurfacing for treating epidermal melasma.
• To assess the impact of VSP Er:YAG laser on melasma severity and patient-reported outcomes.

Main Methods:

• Twenty Thai women diagnosed with epidermal melasma underwent two VSP Er:YAG laser treatments, spaced one month apart.
• Treatment involved two passes using a 7-mm spot size, 300-microsecond pulse duration, and 0.4 J/cm² fluence.
• Efficacy was measured using the Visual Analog Scale (VAS), Melasma Area and Severity Index (MASI) score, and melanin index (MI) at baseline and follow-up intervals up to four months.

Main Results:

• A statistically significant improvement in VAS scores was observed at 1, 2, and 4 months post-treatment (p<.001).
• Significant reduction in MASI scores was noted at the 2-month follow-up compared to baseline (p=.004).
• Melanin index measurements correlated with MASI score ratings, indicating a reduction in pigmentation.

Conclusions:

• VSP Er:YAG laser resurfacing provides effective, albeit temporary, improvement for epidermal melasma.
• Recurrence of melasma was observed following the discontinuation of laser treatments, suggesting the need for maintenance therapies.