Resumen

Objectives: This study assessed treatment with a picosecond laser, using a novel 730-nm picosecond titanium sapphire laser handpiece that specifically targets melanin and melanocytes and a fractional 532-nm handpiece with a ring of diffuse fluence emitted around each of the microbeams. The 532-nm wavelength targets more shallow/epidermal lesions, while the 730-nm wavelength targets deeper/dermal lesions. Introduction: Q-switched (QS) nanosecond lasers are commonly used to treat benign pigmented lesions including dyschromia, but there is increased risk of post inflammatory hyperpigmentation (PIH) and scarring when treating skin of color. Materials / method: Healthy adults with mild to severe benign pigmented lesions received up to four picosecond laser treatments, at 6-week intervals, to the face with the 532-nm handpiece and/or the 730-nm handpiece for both face and off-face treatments. Investigator assessment of pigment improvement was done at the 3-month follow-up post final treatment, using a 5-Point Pigment Improvement Scale (0=0% No improvement to 4=75-100% Excellent response). Subjects reported satisfaction with treatment outcome at the 3-month follow-up, using a 5-point Likert scale. Results: 92 subjects with Skin Types II-V underwent treatments to the face and/or body for both epidermal and mixed epidermal and dermal pigmentation. Full-face treatments were performed with the 532-nm and focal treatments of face and body were performed with the 730-nm handpiece .80% responded positively to the treatment with the majority (79%) showing “Good” to Excellent” improvement. Edema, erythema, whitening and darkening of pigment resolved within several days. The overall rate for PIH and rebound melasma was 8% and resolved with 4% hydroquinone cream. No scarring was reported. Conclusion: A series of 3-4 picosecond laser treatments, with the 532-nm handpiece, and focal treatments with the 730-nm handpiece to the face and body resulted in significant pigment improvement and high patient satisfaction with treatment outcome. PIH and rebound melasma rate was low in dark-skinned subjects. Longer-term follow-up in a larger study cohort is warranted.