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Study Examines Laser Treatment for Melasma


A recent study examines the picosecond laser for treatment of mixed-type melasma in darker skin types.

The American Society for Laser Medicine and Surgery recently published a study observing the efficacy of a 755-nm picosecond laser with and without diffractive lens array (DLA) for the treatment of melasma in Asian patients.

Melasma, which primarily affects women, especially those with darker skin types, is traditionally treated with topical medications and chemical peels. However, because of the recurrent nature of melasma and side effects, many patients seek alternative laser and light treatment options.

Study authors examined the picosecond laser, with its inherent photoacoustic mechanisms, as a new treatment opportunity for patients with melasma.

The randomized, controlled, split-face, prospective study included 18 female Asian patients with Fitzpatrick skin types IV through V with mixed-type melasma, described as melanin presence in both the epidermis and dermis.

Patients were randomly treated with the PicoSure 755-nm picosecond laser (Cynosure) and received a fractionated beam on one side of the face and full beam on the other. Each patient received five treatments at one-month intervals.

Both objective and subjective evaluations of melasma pigment clearance and adverse effects were taken at baseline, one month after the third treatment, and one, three and six months after the final treatment.

When comparing baseline photographs with those taken post-treatment, blinded observers subjectively assessed pigment clearance and patient satisfaction using a 0- to 4-point quartile grading scale, where 0 is no improvement and 4 is ≥76% improvement.

Researchers found that pigment clearance improved significantly on each treatment side at 6-month follow up. However, physician-rating scores did not return statistically significant differences at any of patient follow-up. Notably, there was a lower incidence of post-inflammatory hyperpigmentation with full-beam treatment.

“A 755‐nm picosecond laser is safe and effective for the treatment of melasma in dark‐skinned individuals. The use of DLA does not provide additional benefit over the flat optics in clearing pigmentation,” authors conclude.

Full text is available for additional study details.


Manuskiatti W, Yan C, Tantrapornpong P, Cembrano KAG, Techapichetvanich T, Wanitphakdeedecha R. A Prospective, Split-Face, Randomized Study Comparing a 755-nm Picosecond Laser With and Without Diffractive Lens Array in the Treatment of Melasma in Asians. Lasers Surg Med. 2020; epub ahead of print.

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