Novel melasma therapy using combined low fluence and microsecond pulse Q switched 1064 nm neodymium doped yttrium aluminium garnet laser

Abstract Low-fluence Q-switched (LFQS) 1064-nm Nd: YAG laser treatment has become a standard approach for managing melasma. This study aimed to evaluate the efficacy and safety of a dual-mode approach—LFQS combined with microsecond pulse width (MPW) mode—for treating melasma. In this prospective, si...

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Main Authors: Xianglei Wu, Qingqing Cen, Xiaoxi Lin, Ying Shang, Xue Wang, Zhen Zhang
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-10129-4
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author Xianglei Wu
Qingqing Cen
Xiaoxi Lin
Ying Shang
Xue Wang
Zhen Zhang
author_facet Xianglei Wu
Qingqing Cen
Xiaoxi Lin
Ying Shang
Xue Wang
Zhen Zhang
author_sort Xianglei Wu
collection DOAJ
description Abstract Low-fluence Q-switched (LFQS) 1064-nm Nd: YAG laser treatment has become a standard approach for managing melasma. This study aimed to evaluate the efficacy and safety of a dual-mode approach—LFQS combined with microsecond pulse width (MPW) mode—for treating melasma. In this prospective, single-center, evaluator-blinded, split-face clinical trial, 28 patients with melasma were enrolled. One half of each face was treated using LFQS alone, whereas the other half received LFQS + MPW. Follow-ups were conducted at 1, 3, 6, and 12 months post-treatment. Of the 28 patients, 21 completed all treatments and follow-ups (5–10 sessions in total). Compared with baseline, the average Melasma Area and Severity Index score significantly decreased at 1 and 3 months. However, no significant change was observed at 6 and 12 months. The melanin index (MI) decreased significantly on both sides at 1 and 6 months, with the treatment side maintaining a significantly lower MI at 12 months. Although MI increased at 6 and 12 months, the increase was significantly less on the treatment side compared with the control side. VISIA analysis showed a significant bilateral reduction in facial pigmentation index at 1, 6, and 12 months, although the difference between sides was not statistically significant. However, the treatment side showed a significantly greater reduction in red area index at 1 and 6 months. No treatment-related adverse events were reported. The combination of low-fluence and MPW modes of Q-switched 1064-nm Nd: YAG laser is a safe and effective treatment for melasma. This dual-mode approach may help reduce relapse rates within 3 months after treatment discontinuation.
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spelling doaj-art-bc2d0274ffc54bb58afd357a8d4b80092025-08-20T03:04:38ZengNature PortfolioScientific Reports2045-23222025-07-011511910.1038/s41598-025-10129-4Novel melasma therapy using combined low fluence and microsecond pulse Q switched 1064 nm neodymium doped yttrium aluminium garnet laserXianglei Wu0Qingqing Cen1Xiaoxi Lin2Ying Shang3Xue Wang4Zhen Zhang5Department of Laser and Aesthetic Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineDepartment of Dermatology, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineDepartment of Laser and Aesthetic Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineDepartment of Laser and Aesthetic Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineDepartment of Dermatology, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineDepartment of Laser and Aesthetic Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineAbstract Low-fluence Q-switched (LFQS) 1064-nm Nd: YAG laser treatment has become a standard approach for managing melasma. This study aimed to evaluate the efficacy and safety of a dual-mode approach—LFQS combined with microsecond pulse width (MPW) mode—for treating melasma. In this prospective, single-center, evaluator-blinded, split-face clinical trial, 28 patients with melasma were enrolled. One half of each face was treated using LFQS alone, whereas the other half received LFQS + MPW. Follow-ups were conducted at 1, 3, 6, and 12 months post-treatment. Of the 28 patients, 21 completed all treatments and follow-ups (5–10 sessions in total). Compared with baseline, the average Melasma Area and Severity Index score significantly decreased at 1 and 3 months. However, no significant change was observed at 6 and 12 months. The melanin index (MI) decreased significantly on both sides at 1 and 6 months, with the treatment side maintaining a significantly lower MI at 12 months. Although MI increased at 6 and 12 months, the increase was significantly less on the treatment side compared with the control side. VISIA analysis showed a significant bilateral reduction in facial pigmentation index at 1, 6, and 12 months, although the difference between sides was not statistically significant. However, the treatment side showed a significantly greater reduction in red area index at 1 and 6 months. No treatment-related adverse events were reported. The combination of low-fluence and MPW modes of Q-switched 1064-nm Nd: YAG laser is a safe and effective treatment for melasma. This dual-mode approach may help reduce relapse rates within 3 months after treatment discontinuation.https://doi.org/10.1038/s41598-025-10129-4MelasmaLaserQ-switched laserPigmentationRelapse
spellingShingle Xianglei Wu
Qingqing Cen
Xiaoxi Lin
Ying Shang
Xue Wang
Zhen Zhang
Novel melasma therapy using combined low fluence and microsecond pulse Q switched 1064 nm neodymium doped yttrium aluminium garnet laser
Scientific Reports
Melasma
Laser
Q-switched laser
Pigmentation
Relapse
title Novel melasma therapy using combined low fluence and microsecond pulse Q switched 1064 nm neodymium doped yttrium aluminium garnet laser
title_full Novel melasma therapy using combined low fluence and microsecond pulse Q switched 1064 nm neodymium doped yttrium aluminium garnet laser
title_fullStr Novel melasma therapy using combined low fluence and microsecond pulse Q switched 1064 nm neodymium doped yttrium aluminium garnet laser
title_full_unstemmed Novel melasma therapy using combined low fluence and microsecond pulse Q switched 1064 nm neodymium doped yttrium aluminium garnet laser
title_short Novel melasma therapy using combined low fluence and microsecond pulse Q switched 1064 nm neodymium doped yttrium aluminium garnet laser
title_sort novel melasma therapy using combined low fluence and microsecond pulse q switched 1064 nm neodymium doped yttrium aluminium garnet laser
topic Melasma
Laser
Q-switched laser
Pigmentation
Relapse
url https://doi.org/10.1038/s41598-025-10129-4
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