Objectives: 1. Understand the histological changes by the 1064/532 fractional picosecond lasers.
2. Know the strategies of single or combination of different wavelengths for better outcome in the treatment of melasma
Introduction: Melasma is a troublesome pigmentary problem in Asians. Many treatment modalities are used to fight melasma, but none is the almighty solution. Although Q-switched 1064nm laser toning has good effects, complications such as mottled dyspigmentation would sometimes be encountered because of the accumulated photothermal damage to the melanocytes. Picosecond lasers have shorter pulse duration than the nanosecond lasers, which exerts more photomechanical effects with less photothermal damage. We want to find the better treatment strategy of using picesecond lasers for melasma.
Materials / method: For histology, we did skin biopsies for the fractional picosecond lasers with 1064nm and 532nm wavelengths. For clinical trial, we used single or combination of different wavelengths to treat melasma in Asian patients.
Results: Histologically, laser-induced optical breakdown (LIOB) took place above a certain threshold fluence both in 1064nm and 532nm fractional picosecond lasers. Clinically, treatment with 1064nm picotoning, or in combination with fractional 1064nm or 532nm handpieces, all gave good results.
Conclusion: Melasma in Asians can be treated by picosecond lasers with 1064nm picosecond laser toning monotherapy. There seems to be beneficial effects when it is combined with fractional 1064/532nm handpiece.
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