Feng Jiayi, Huang Lvping
From the Laser Aesthetic Center, Plastic Surgery Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences.
Plast Reconstr Surg. 2023 Apr 1;151(4):772-777. doi: 10.1097/PRS.0000000000009994. Epub 2022 Dec 6.
Melasma is a refractory pigmentary disorder. The picosecond Nd:YAG 1064-nm laser (PSNY) has promise as a better treatment for melasma with few side effects and favorable therapeutic efficacy. The authors evaluated the efficacy and safety of PSNY and the nanosecond Q-switched Nd:YAG 1064-nm laser (QSNY) in patients with melasma.
Eighteen patients were recruited to receive the two types of laser treatment on split faces. The modified Melasma Area Severity Index was assessed at baseline and the 3-month follow-up visit. The recurrence rate and the patients' self-satisfaction assessment were also evaluated.
The two treated sides showed statistically significant decreases in modified Melasma Area Severity Index score after treatment at follow-up compared with baseline ( P < 0.001). There was no statistically significant difference between the modalities ( P = 0.873) or the patients' satisfaction assessment ( P = 0.287). The visual analogue scale pain assessment score showed that the QSNY was more painful than the PSNY counterpart ( P = 0.007). The recurrence rate was the same for the two treated sides (12.5%).
PSNY is a better choice compared with QSNY with less treatment pain and postprocedure erythema as well as lower potential risk of exacerbation of melasma.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
黄褐斑是一种难治性色素沉着性疾病。皮秒钕：钇铝石榴石1064纳米激光（PSNY）有望成为治疗黄褐斑的更佳方法，副作用少且治疗效果良好。作者评估了PSNY和纳秒调Q钕：钇铝石榴石1064纳米激光（QSNY）治疗黄褐斑患者的疗效和安全性。
招募18例患者，在面部两侧分别接受两种激光治疗。在基线和3个月随访时评估改良黄褐斑面积严重程度指数。还评估了复发率和患者的自我满意度。
与基线相比，随访时治疗后的两侧改良黄褐斑面积严重程度指数评分均有统计学显著下降（P < 0.001）。两种治疗方式之间（P = 0.873）或患者满意度评估（P = 0.287）无统计学显著差异。视觉模拟评分法疼痛评估得分显示，QSNY比PSNY更痛（P = 0.007）。两侧的复发率相同（12.5%）。
与QSNY相比，PSNY是更好的选择，治疗疼痛和术后红斑更少，黄褐斑加重的潜在风险更低。
临床问题/证据水平：治疗性，II级。
