Vasanop Vachiramon1, Sinijchaya Sahawatwong, Punyaphat Sirithanabadeekul. 1. *Ramathibodi Laser Center, Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; and †Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand.
Abstract
BACKGROUND:Low-fluenceQ-switched neodymium-doped yttrium-aluminum-garnet 1,064-nm laser (LFQS) and glycolic acid (GA) peeling have been reported as a treatment option for melasma. However, there are limited data on their efficacy in men. OBJECTIVE: To compare the efficacy and safety of LFQS monotherapy with combined LFQS and 30% GA peeling in male patients with melasma. MATERIALS AND METHODS:Fifteen males with mixed type melasma were randomized to receive 5 weekly sessions of LFQS on one side of the face and LFQS plus 30% GA peeling on the contralateral side and were followed for 12 weeks. Twelve patients completed the protocol. RESULTS:Mean relative lightness index (RL*I) of the combined treatment side was lowered throughout the study period, with the maximal improvement of 52.3% reduction at the fourth week follow-up (p = .023). Patient self-assessment was favorable in the combined treatment. However, the mean RL*I increased at 8 and 12 weeks of follow-up. One subject (8.3%) developed guttate hypopigmentation, which did not resolve by the 12-week follow-up. CONCLUSION:Low-fluence Q-switched neodymium-doped yttrium-aluminum-garnet 1,064-nm laser combined with GA peeling temporarily reduced melasma in men, but the incidence of side effects does not justify the short-lived benefits of this procedure. This technique requires further study.
RCT Entities:
BACKGROUND: Low-fluence Q-switched neodymium-doped yttrium-aluminum-garnet 1,064-nm laser (LFQS) and glycolic acid (GA) peeling have been reported as a treatment option for melasma. However, there are limited data on their efficacy in men. OBJECTIVE: To compare the efficacy and safety of LFQS monotherapy with combined LFQS and 30% GA peeling in male patients with melasma. MATERIALS AND METHODS: Fifteen males with mixed type melasma were randomized to receive 5 weekly sessions of LFQS on one side of the face and LFQS plus 30% GA peeling on the contralateral side and were followed for 12 weeks. Twelve patients completed the protocol. RESULTS: Mean relative lightness index (RL*I) of the combined treatment side was lowered throughout the study period, with the maximal improvement of 52.3% reduction at the fourth week follow-up (p = .023). Patient self-assessment was favorable in the combined treatment. However, the mean RL*I increased at 8 and 12 weeks of follow-up. One subject (8.3%) developed guttate hypopigmentation, which did not resolve by the 12-week follow-up. CONCLUSION: Low-fluence Q-switched neodymium-doped yttrium-aluminum-garnet 1,064-nm laser combined with GA peeling temporarily reduced melasma in men, but the incidence of side effects does not justify the short-lived benefits of this procedure. This technique requires further study.