Melasma treatment with a 1064 nm, picosecond‐domain laser with a fractionated multibeam lens array

Abstract

AbstractBackground and ObjectivesPicosecond‐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 MethodsTwenty 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.ResultsBlinded 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.ConclusionThe 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.