Subtype-Specific Response to Fractional-Mode Q-Switched Ruby Laser in Melasma: A Prospective Single-Blind Clinical...

Area of Science:

• Dermatology
• Laser Therapy
• Hyperpigmentation Disorders

Background:

• Melasma is a chronic facial hyperpigmentation disorder with diverse presentations.
• It exhibits both pigmentary and vascular components, influencing treatment response.
• Understanding subtype differences is crucial for effective management.

Purpose of the Study:

• To compare the efficacy of fractional-mode 694 nm Q-switched ruby laser on two melasma subtypes.
• To evaluate treatment outcomes in pigmentary melasma (M) versus pigmentary-vascular melasma (M+V).
• To determine if baseline classification predicts laser treatment response.

Main Methods:

• Prospective, single-center, single-blind clinical study.
• 100 women with facial melasma classified as M (n=50) or M+V (n=50) via clinical examination and dermoscopy.
• Three laser sessions at 4-week intervals; outcomes assessed using MASI, VISIA, and dermoscopic scores.

Main Results:

• Pigmentary melasma (M) showed significantly greater MASI percentage reduction (71.1%) compared to M+V (51.2%) (P < 0.001).
• Higher rates of ≥50% MASI improvement were observed in M (95.2%) versus M+V (56.3%) (P < 0.001).
• M subtype independently predicted greater treatment response; treatment was well-tolerated.

Conclusions:

• Fractional-mode 694 nm Q-switched ruby laser is effective for both melasma subtypes.
• Pigmentary melasma demonstrates a more favorable response to this laser treatment.
• Clinicodermoscopic classification and multimodal assessment aid in personalized laser therapy and outcome evaluation.