Feng Wei, Yang Lichang
Center for Plastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China.
Department of Breast Oncoplastic Surgery, Hunan Cancer Hospital and the Affliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
J Cosmet Dermatol. 2025 Feb;24(2):e70018. doi: 10.1111/jocd.70018.
Laser-induced post-inflammatory hyperpigmentation (PIH)is a common adverse reaction in Asian individuals. Dark skin and incorrect laser parameters are common causes, but PIH is often unexpected for patients. Obvious hyperpigmentation can lead to an ugly appearance and severe anxiety. Therefore, a fast and effective treatment for laser-induced PIH is necessary. In this article, we attempted to demonstrate that a low-fluence Q-switch (QS) 1064 nm laser combined with oral tranexamic acid (TXA) is a quick and safe method for the clearance of laser-induced PIH.
A retrospective cohort study, adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, spanning 2 years (2021-2023) was conducted on 23 patients aged between 29 and 58 years. These patients were diagnosed with laser-induced PIH for < 3 months. The treatment regimen was a low-fluence QS1064 nm laser combined with oral TXA, oral TXA was first taken, and a low-fluence QS1064 nm laser was used for at least 1 month after the last laser was applied. Three to six laser treatments were subsequently applied. After treatment, the pigment color and patient satisfaction were assessed to evaluate the effectiveness of the treatment options.
Twenty patients were enrolled in the study, the average laser treatments were 4.3 ± 0.865 times. The Melasma Area and Severity Index (MASI) score decreased from 9.325 ± 3.38 before treatment to 5.97 ± 2.37. After the first treatment, the MASI score decreased by approximately 40%. Two months after the last treatment, the MASI score decreased to 0.93 ± 1.06, and there was a statistically significant difference in the MASI score before and after treatment (p < 0.05). Patient satisfaction scores revealed that 95% of patients were highly or strongly satisfied with the decrease in the intensity of the PIH color, with a moderate response rate of 1 (5%). The patients thought that the pigment removal speed was 75% (15) very fast or fast, 20% (4) moderate, and 5% (1) slow.
The results of this study demonstrated the quick and safe removal of laser-induced PIH following treatment with low-fluence QS1064 nm laser combined with oral TXA. Providing such a protocol is indeed one of the primary objectives of this article.
激光诱导的炎症后色素沉着（PIH）在亚洲人群中是一种常见的不良反应。肤色较深和激光参数设置不当是常见原因，但PIH对患者来说往往难以预料。明显的色素沉着会导致容貌难看和严重焦虑。因此，有必要对激光诱导的PIH进行快速有效的治疗。在本文中，我们试图证明低能量调Q（QS）1064纳米激光联合口服氨甲环酸（TXA）是清除激光诱导的PIH的一种快速且安全的方法。
一项回顾性队列研究，遵循加强流行病学观察性研究报告（STROBE）指南，对23例年龄在29至58岁之间的患者进行了为期2年（2021 - 2023年）的研究。这些患者被诊断为激光诱导的PIH且病程小于3个月。治疗方案为低能量QS1064纳米激光联合口服TXA，先服用口服TXA，在最后一次激光治疗后至少1个月使用低能量QS1064纳米激光。随后进行3至6次激光治疗。治疗后，评估色素颜色和患者满意度以评价治疗方案的有效性。
20例患者纳入研究，平均激光治疗次数为4.3 ± 0.865次。黄褐斑面积和严重程度指数（MASI）评分从治疗前的9.325 ± 3.38降至5.97 ± 2.37。首次治疗后，MASI评分下降了约40%。最后一次治疗后两个月，MASI评分降至0.93 ± 1.06，治疗前后MASI评分差异有统计学意义（p < 0.05）。患者满意度评分显示，95%的患者对PIH颜色强度的降低高度或非常满意，中度反应率为1例（5%）。患者认为色素去除速度非常快或快的占75%（15例），中度的占20%（4例），慢的占5%（1例）。
本研究结果表明，低能量QS1064纳米激光联合口服TXA治疗可快速、安全地清除激光诱导的PIH。提供这样一种方案确实是本文的主要目标之一。
