Qiu Houhuang, Zhu Yuyun, Wu Bingliang, Zhou Siyuan, Zhou Xiang, Pan Fuqiang
Department of Medical Cosmetology, Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
Department of Medical Cosmetology, Langdong Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
Clin Cosmet Investig Dermatol. 2025 Aug 8;18:1889-1900. doi: 10.2147/CCID.S532685. eCollection 2025.
Melasma is a chronic, relapsing pigmentary disorder with a high recurrence rate. While multiple treatment options exist, long-term oral therapies are often limited by poor patient tolerance. Laser therapy offers a non-invasive and convenient alternative; however, Low-fluence QS 1064 nm Nd: YAG monotherapy has shown inconsistent efficacy and frequent relapse. To investigate a more effective laser-based approach, this retrospective study evaluates the clinical outcomes of combining Low-fluence QS 1064 nm Nd: YAG laser, Fractional-mode QS 1064 nm Nd: YAG laser, and Long-pulsed 1064 nm Nd: YAG laser in the treatment of melasma.
This retrospective observational study enrolled 43 patients with clinically diagnosed melasma, all of whom underwent treatment with a 1064 nm Nd: YAG laser using a combination of three modes: low-fluence QS, fractional-mode QS, and long-pulsed settings. Each patient underwent a total of three treatment sessions. Clinical improvement was assessed using the MASI at baseline and one month after each session. Adverse events were documented throughout the treatment course. Patients were followed for 12 months post-treatment to evaluate recurrence and satisfaction.
MASI scores significantly decreased following the final treatment compared to baseline [13.50 (8.40-19.10) vs 5.86 ± 3.38, p < 0.001]. At the 12-month follow-up, the recurrence rate was 18.60%, with a patient satisfaction rate of 72.10%. Post-inflammatory hyperpigmentation occurred in 6.97% of cases, and transient erythema or edema in 46.51%, all of which resolved spontaneously.
In this retrospective observational study, combination therapy with low-fluence QS 1064 nm Nd: YAG laser, fractional-mode QS 1064 nm Nd: YAG laser, and long-pulsed 1064 nm Nd: YAG laser demonstrated favorable efficacy in the treatment of melasma, with low recurrence rates and a low incidence of adverse events. These findings suggest that this combined laser approach is a promising and well-tolerated treatment modality for melasma.
黄褐斑是一种慢性复发性色素沉着紊乱疾病，复发率很高。虽然有多种治疗选择，但长期口服疗法往往因患者耐受性差而受到限制。激光治疗提供了一种非侵入性且便捷的替代方法；然而，低能量调Q 1064nm钕：钇铝石榴石激光单一疗法的疗效并不一致，且频繁复发。为了研究一种更有效的基于激光的治疗方法，这项回顾性研究评估了联合使用低能量调Q 1064nm钕：钇铝石榴石激光、分数模式调Q 1064nm钕：钇铝石榴石激光和长脉冲1064nm钕：钇铝石榴石激光治疗黄褐斑的临床效果。
这项回顾性观察性研究纳入了43例临床诊断为黄褐斑的患者，所有患者均接受了1064nm钕：钇铝石榴石激光治疗，采用低能量调Q、分数模式调Q和长脉冲设置三种模式联合治疗。每位患者总共接受三次治疗。在基线时以及每次治疗后1个月使用黄褐斑面积和严重程度指数（MASI）评估临床改善情况。在整个治疗过程中记录不良事件。治疗后对患者随访12个月，以评估复发情况和满意度。
与基线相比，最终治疗后MASI评分显著降低[13.50（8.40 - 19.10）对5.86±3.38，p < 0.001]。在12个月的随访中，复发率为18.60%，患者满意率为72.10%。炎症后色素沉着发生在6.97%的病例中，短暂性红斑或水肿发生在46.51%的病例中，所有这些均自发消退。
在这项回顾性观察性研究中，联合使用低能量调Q 1064nm钕：钇铝石榴石激光、分数模式调Q 1064nm钕：钇铝石榴石激光和长脉冲1064nm钕：钇铝石榴石激光治疗黄褐斑显示出良好的疗效，复发率低且不良事件发生率低。这些发现表明，这种联合激光治疗方法是一种有前景且耐受性良好的黄褐斑治疗方式。
