Main Line Center for Laser Surgery, Ardmore, Pennsylvania, USA.
SUNY Downstate Health Sciences University, New York, USA.
Lasers Surg Med. 2023 Nov;55(9):801-808. doi: 10.1002/lsm.23723. Epub 2023 Sep 5.
Picosecond-domain lasers have been fitted with fractionated optics for dermal remodeling. This study evaluates the safety and efficacy of a multiwavelength picosecond-domain laser, using a 1064 nm multibeam lens array, for improving the appearance of melasma.
STUDY DESIGN/MATERIALS AND METHODS: Twenty adults with a clinical diagnosis of melasma were enrolled and received 4 monthly 1064-nm, 450 ps laser treatments delivered with a 10 × 10 fractional array of 150 µm microbeams. Cosmetic units with melasma were treated with fluences ranging from 1.7 to 2.9 mJ/microbeam with a repetition rate of 6 Hz. Treatment effect was evaluation of digital images by dermatologists blinded as to the treatment conditions, comparing baseline and 3- and 8-month post-treatment images. Modified melasma area and severity index (mMASI) scores were determined by the study investigator based on clinical photography. Subject self-assessment of treatment effects was also recorded.
Blinded reviewers correctly identified the post-treatment image in 16 of the 20 image sets (80%). Ratings demonstrated statistically significant (p < 0.001) improvement on an 11-point scale at both the 3- and 8-month timepoints for a mean improvement of 3.7 point (range -8 to 10) or 37% improvement at the 3-month follow-up, and 2.7 (range -8 to 9) or 27% at the 8-month follow-up for all subjects. The average mMASI score showed highly significant reduction at both the 3- and 8-month follow-ups compared to baseline (p < 0.01). Most subjects (90%) were satisfied with the treatment outcome in melasma at both follow-ups, which is consistent with the treatment outcome and mMASI scores.
The fractionated, picosecond-domain, 1064 nm laser is safe and effective for improving melasma and should be considered as an adjunct to topical treatment regimens and sun-protection for management of melasma.
皮秒域激光已配备了用于皮肤重塑的分段式光学器件。本研究评估了一种多波长皮秒域激光（使用 1064nm 多光束透镜阵列）的安全性和有效性，该激光用于改善黄褐斑的外观。
研究设计/材料和方法：20 名成人临床诊断为黄褐斑，接受了 4 次每月的 1064nm、450ps 激光治疗，采用 150μm 微光束的 10×10 分段式阵列进行治疗。用 6Hz 的重复率对有黄褐斑的美容单位进行 1.7 至 2.9mJ/微光束的治疗。根据临床摄影，由研究研究者确定改良的黄褐斑面积和严重程度指数（mMASI）评分。还记录了患者对治疗效果的自我评估。
20 个图像组中的 16 个（80%）被盲法评审者正确识别出了治疗后的图像。评分显示，在 3 个月和 8 个月时，在 11 分制上均有统计学意义（p<0.001）的改善，平均改善 3.7 分（范围-8 至 10）或 37%，在 3 个月随访时，2.7 分（范围-8 至 9）或 27%，所有患者均如此。与基线相比，在 3 个月和 8 个月随访时，平均 mMASI 评分均显著降低（p<0.01）。在两次随访中，90%的患者对治疗黄褐斑的效果感到满意，这与治疗效果和 mMASI 评分一致。
分段式皮秒域 1064nm 激光治疗黄褐斑安全有效，可作为局部治疗方案和防晒措施的辅助手段，用于治疗黄褐斑。
