Chen Changhan, Ke Youhui
Department of Cosmetology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Affiliated Zhejiang Chinese Medical University, Wenzhou, Zhejiang, China.
Skin Res Technol. 2025 Aug;31(8):e70177. doi: 10.1111/srt.70177.
Melasma is a chronic pigmented lesion on the face that is challenging to treat. Single laser treatments are usually ineffective. Recently, picosecond lasers are becoming an emerging option for the treatment of melasma. This study aimed to evaluate the efficacy and safety of fractional and non-fractional picosecond Nd:YAG lasers (PSNL) combined with fractional picosecond KTP laser (PSKL) on melasma in female Chinese.
Forty-eight Chinese patients with facial melasma were selected and divided into two groups. Every 4 weeks, each patient received one treatment, for a total of six treatments. Treatment was administered to 24 patients using fractional and non-fractional PSNL in the Nd:YAG group and fractional PSKL combined with fractional and non-fractional PSNL in the Nd:YAG+KTP group. Pain scores and adverse reactions were noted following each treatment, and the modified Melasma Area Severity Index (mMASI) and patient satisfaction were assessed 1 month following every two treatments.
The mMASI scores of both groups showed a considerable decline from the baseline. Following six treatments, the Nd:YAG+KTP group's mean mMASI score was 2.29 ± 0.82, while the Nd:YAG group was 2.87 ± 0.68. This difference was statistically significant (p < 0.05). At every stage of the procedure, the Nd:YAG+KTP group experienced higher patient satisfaction than the Nd:YAG group. In comparison to the Nd:YAG group, which had a pain score of 2.75 (2.54, 3.00), the Nd:YAG+KTP group had a higher pain score of 3.00 (3.00, 3.17). During the study, no severe side effects were seen in the treated areas, including blisters, hypopigmentation, or post-inflammatory hyperpigmentation (PIH).
The efficacy of fractional and non-fractional PSNL combined with fractional PSKL in the treatment of melasma is significantly better than that of using single wavelength fractional and non-fractional PSNL, with higher patient satisfaction and less adverse reactions.
黄褐斑是一种面部慢性色素沉着性病变，治疗具有挑战性。单次激光治疗通常无效。近年来，皮秒激光正成为治疗黄褐斑的一种新兴选择。本研究旨在评估剥脱性和非剥脱性皮秒钕钇铝石榴石激光（PSNL）联合剥脱性皮秒磷酸钛钾激光（PSKL）治疗中国女性黄褐斑的疗效和安全性。
选取48例面部黄褐斑的中国患者并分为两组。每4周进行一次治疗，共治疗6次。钕钇铝石榴石组对24例患者使用剥脱性和非剥脱性PSNL进行治疗，钕钇铝石榴石+磷酸钛钾组使用剥脱性PSKL联合剥脱性和非剥脱性PSNL进行治疗。每次治疗后记录疼痛评分和不良反应，每两次治疗后1个月评估改良黄褐斑面积严重程度指数（mMASI）和患者满意度。
两组的mMASI评分均较基线有显著下降。6次治疗后，钕钇铝石榴石+磷酸钛钾组的平均mMASI评分为2.29±0.82，而钕钇铝石榴石组为2.87±0.68。差异具有统计学意义（p<0.05）。在治疗过程的每个阶段，钕钇铝石榴石+磷酸钛钾组的患者满意度均高于钕钇铝石榴石组。与钕钇铝石榴石组疼痛评分为2.75（2.54，3.00）相比，钕钇铝石榴石+磷酸钛钾组的疼痛评分更高，为3.00（3.00，3.17）。在研究期间，治疗区域未见严重副作用，包括水疱、色素减退或炎症后色素沉着（PIH）。
剥脱性和非剥脱性PSNL联合剥脱性PSKL治疗黄褐斑的疗效明显优于使用单一波长的剥脱性和非剥脱性PSNL，患者满意度更高，不良反应更少。
