Macular Pigmentation Following Low Fluence Nd:YAG Laser Procedure at Sites of Gold Thread Implantation

Use of gold thread rejuvenation and Q-switched low fluence neodymium-doped yttrium aluminum garnet (Nd:YAG) laser treatments have become a recent fashion trend in the skin care industry, and are frequently used for skin care management. Although the efficacy and side effects of the individual procedures have been well documented, the combined effects of the two treatments have not been reported. We describe a unique case of macular pigmentation on the face, resulting from the low fluence (3 J/cm²) Nd:YAG laser procedure solely at the sites of gold thread implantation. A skin biopsy revealed rod-shaped foreign material and tiny golden colored granules surrounded by minor inflammatory infiltrates. Therefore, the use of a Nd:YAG laser at a specific wavelength (potentially 1064 nm) may trigger macular pigmentation when in contact with pre-implanted gold threads by as yet unknown mechanism.