• Medical Lasers
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• v.10 no.1
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• pp.45-48
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• 2021

Background and Objectives Among the numerous available therapies, the usefulness of laser treatment has been proven in melasma, especially for refractory to topical agents or chemical peels. This study evaluated the effectiveness of 694-nm wavelength fractional toning ruby laser in melasma presenting on the malar area. Materials and Methods This was a retrospective study of 40 melasma patients treated with 694-nm wavelength ruby fractional toning laser for a total of 8 cycles at intervals of 2 to 3 weeks. Two independent investigators assessed the photographic findings and evaluated the severity of melasma by applying the Melasma Severity Scale (MSS). Subject satisfaction score was also surveyed at every visit. Results After the 4th treatment, subjects were continuously satisfied with their results. At the 8th visit and 1-month after the last treatment, MSS was determined to be significantly improved as compared to the first visit. One case of minor hypopigmentation was reported, but was resolved after one month. Conclusion Application of 694-nm wavelength fractional toning ruby laser for treating melasma on the malar area showed significant improvement in the MSS. Moreover, the treatment could be repeatedly applied, with low complication rate and significant patient satisfaction.

• Medical Lasers
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• v.10 no.1
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• pp.49-51
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• 2021

The perioral region, which is one of the most conspicuous parts of the face, plays a significant role in interpersonal communication. However, the perioral region is highly susceptible to scarring and pigmentation and is difficult to treat. The causes of perioral hyperpigmentation are many, including physiologic reasons, systemic diseases, drugs, and infections. In the treatment of perioral hyperpigmentation, the cause of the disease must be diagnosed first. Management includes lifestyle modifications such as reducing the UVA exposure time, use of topical treatments including hydroquinone and retinoids, and physical therapy including laser therapy. We report a case of perioral hyperpigmentation treated with 1,064-nm Q-switched neodymium:yttrium-aluminum-garnet laser toning.

• Medical Lasers
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• v.9 no.2
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• pp.166-171
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• 2020

Background and Objectives Melasma is an acquired pigmentary disorder characterized by brown or dark brown colored macules and patches which mostly involve the face. Compared to nanosecond lasers, picosecond lasers have fewer adverse effects on surrounding tissues and give better results for melanin fragmentation. The purpose of this study was to evaluate the efficacy of the pico-toning technique using a low fluence 1,064-nm Nd:YAG laser on melasma patients. Materials and Methods This study is a retrospective analysis of melasma cases treated using the pico-toning technique from June 2017 to November 2020. Based on photographic images, the modified Melasma Area and Severity Index (mMASI) score was blind evaluated by two independent plastic surgeons. Patient satisfaction was assessed through a 5-point Likert scale questionnaire after treatment sessions. All adverse effects and complications were reviewed based on medical records. Results A total of 23 patients were included in the study. The mMASI scores for baseline and 2 months after the last procedure were 5.1 ± 1.4 and 2.6 ± 0.4, respectively. The mean mMASI score reduced significantly after the treatment session (p < 0.05). The patient satisfaction score with the procedure was 3.8 ± 1.0. The subject satisfaction score and difference in the mMASI score before the procedure and 2 months after the last procedure showed a significant correlation. Adverse effects observed in this study were erythema (n = 1) and edema (n = 1). Conclusion The results of the study show that the pico-toning technique is effective in Asian patients with melasma. We believe that safety was enhanced by using low fluence, and thus better results were achieved with fewer adverse effects.