Alavi Shiva, Abolhasani Ehsan, Asadi Sharin, Nilforoushzadeh Mohammadali
Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.
J Lasers Med Sci. 2017 Winter;8(1):1-6. doi: 10.15171/jlms.2017.01. Epub 2017 Jan 8.
Ablative and nonablative lasers have been used to treat melasma. We aimed to assess and compare the combining Q-switched Nd:YAG laser (QSNYL) and fractional erbium:YAG laser (FEYL) with QSNYL alone in treatment of melasma. This randomized controlled clinical trial was performed in our Research Center during 2013-2014. Women with melasma and without a history of keloid formation, hypersensitivity to hydroquinone, or pigmentary changes due to laser therapy were randomly allocated to receive four sessions of either QSNYL-FEYL combination or QSNYL alone. All patients received topical treatment with Kligman's formula. Before laser therapy and 4 weeks after the last treatment session, patients' skin was assessed for changes in skin color, melanin content, and erythema intensity of melasma lesions quantitatively. Finally, 21 patients in QSNYL-FEYL and 20 in QSNYL group (mean age, 38.57 [5.60] and 42.60 [8.44] years, respectively) completed study. The skin color had become lighter in both groups (mean [SD] percentage change of 56.95 [40.29] and 29.25 [13.20] in QSNYL-FEYL and QSNYL groups, respectively) with significantly better results in QSNYL-FEYL group ( = 0.006). Percentage of decrease of melanin content was significantly higher in QSNYL-FEYL group (22.01 [10.67] vs. 7.69 [4.75]; < 0.001). After adjustment for baseline values, the post treatment intensity of erythema was significantly lower in QSNYL-FEYL group ( < 0.001). The patients reported no adverse events. QSNYL-FEYL was significantly more effective in decreasing melanin content of lesions than QSNYL and led to a lighter skin.
剥脱性和非剥脱性激光已被用于治疗黄褐斑。我们旨在评估并比较调Q开关Nd:YAG激光（QSNYL）联合铒激光（FEYL）与单独使用QSNYL治疗黄褐斑的效果。这项随机对照临床试验于2013年至2014年在我们的研究中心进行。患有黄褐斑且无瘢痕疙瘩形成史、对氢醌无过敏反应或无激光治疗引起色素变化史的女性被随机分配接受四疗程的QSNYL-FEYL联合治疗或单独的QSNYL治疗。所有患者均接受了Kligman配方的局部治疗。在激光治疗前和最后一次治疗疗程后4周，对患者皮肤黄褐斑病变的肤色、黑色素含量和红斑强度变化进行定量评估。最后，QSNYL-FEYL组的21名患者和QSNYL组的20名患者（平均年龄分别为38.57[5.60]岁和42.60[8.44]岁）完成了研究。两组的肤色均变浅（QSNYL-FEYL组和QSNYL组的平均[标准差]变化百分比分别为56.95[40.29]和29.25[13.20]），QSNYL-FEYL组的效果明显更好（P = 0.006）。QSNYL-FEYL组黑色素含量的下降百分比显著更高（22.01[10.67]对7.69[4.75]；P < 0.001）。在对基线值进行调整后，QSNYL-FEYL组治疗后的红斑强度显著更低（P < 0.001）。患者未报告不良事件。与单独使用QSNYL相比，QSNYL-FEYL在降低病变黑色素含量方面显著更有效，并使皮肤更亮。
