Picosecond-domain laser safe and effective adjunct treatment of melasma

Melasma, a stubborn skin condition characterized by unsightly brown or gray-brown patches on the face, may have met its match in a groundbreaking laser treatment, according to a recent study.  Researchers have evaluated the safety and effectiveness of a cutting-edge picosecond-domain laser equipped with fractionated optics, and the results are turning heads in the world of dermatology. 

The study results were published in the journal Lasers in Surgery and Medicine: Energy-based Therapeutics and Diagnostics.

Melasma is a very typical acquired condition characterized by macular hyperpigmented patches in sun-exposed areas of skin. It primarily affects the face's sun-exposed regions, appearing as brown hyperpigmented patches on the forehead, cheeks, chin, nose, upper lip, and also the upper arms. Due to the inflammatory nature of melasma, Q-switched lasers, and fractionated thulium lasers are commonly used to treat melasma apart from the myriad of treatments.  Recent literature shows that picosecond-domain laser treatments can effectively manage melasma. Hence researchers from the U.S.A. conducted a study to investigate the effect of treatment with a 1064-nm picosecond-domain laser on melasma. 

In a study involving 20 adults diagnosed with melasma, participants underwent a series of four monthly laser treatments. These treatments utilized a 1064 nm wavelength laser, delivering precise microbeams in a 10x10 fractional array. The laser fluences, or energy levels, ranged from 1.7 to 2.9 millijoules per microbeam, with a rapid repetition rate of 6 Hz. Blinded dermatologists compared the 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. 

Findings: 

• Blinded dermatologists examining post-treatment images correctly identified the improvements in 80% of cases.
• On an 11-point scale, the ratings showed a statistically significant enhancement at both the 3-month and 8-month follow-up assessments.
• The real breakthrough came with the quantifiable results where a remarkable 37% improvement in melasma appearance was noted at the 3-month follow-up, with an enduring 27% improvement still present at the 8-month mark.

• These results were supported by the Modified Melasma Area and Severity Index (mMASI) scores, which indicated a highly significant reduction in melasma severity at both follow-up assessments compared to the baseline.
• The most encouraging was the satisfaction reported by the participants themselves. An impressive 90% of those who received the laser treatment expressed contentment with the results. 

Thus, though further research and larger clinical trials may be needed to confirm these findings, the picosecond-domain laser's potential to tackle melasma is a promising step forward. With its remarkable 80% success rate in improving melasma appearance, this treatment may soon become a game-changer in the quest for clearer, more radiant skin for those living with this common skin condition.

Further reading: Melasma treatment with a 1064 nm, picosecond-domain laser with a fractionated multi-beam lens array. https://doi.org/10.1002/lsm.23723