from laser of Cutaneous and Aesthetic Surgery June 2012 Volume 5 Issue 2
Q Switch ND YAG for melasma
The most widely use for Melasma treatment
Low Dose Q Switch ND YAG for melasma treatment by these mechanism
- induce sub-lethal injury causing fragmentation and rupture of melanin granule to cytoplasm
- subcellular damage to the upper dermal vascular plexus which is one of the pathogenetic factors in melasma
- subthreshold injury to the surrounding dermis stimulates the formation of collagen resulting in brighter and tighter skin
“laser toning” Technique
- large spot size (6-8 mm)
- low fluence (1.6-3.5 J/cm 2 )
- multiple passed QS 1064 nm Nd:YAG laser
- performed every 1-2 weeks for several weeks.
laser toning complication reported
While few studies document good efficacy with this Technique, several others have found hypopigmentation and depigmentation after a series of laser toning.
other reported complication
- rebound hyperpigmentation
- physical urticaria, acneiform eruption
- and herpes simplex reactivation
cause of hypopigentation for laser toning technique
- high fluences causing direct phototoxicity and cellular destruction of melanocyte
- subthreshold additive effect of multiple doses
- intrinsic unevenness of skin pigmentation
- non-uniform laser energy output.
suggestion to avoid serious side effect
should be avoid
- too many (>6-10)
- too frequent (every week) laser sessions
- Hypopigmentation should be looked for after every session and further treatments should be stopped.