Effectiveness of the Pico-toning Technique for the Treatment of Melasma with a Low Fluence 1,064-nm Nd:YAG Laser in Asian Patients
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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.
Abstract
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.
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