title: A randomized, observer-blinded, comparison of combined 1064-nm Q-switched neodymium-doped yttrium-aluminium-garnet laser plus 30% glycolic acid peel vs. laser monotherapy to treat melasma.
abstract: BACKGROUND
  Melasma is a common pigmentary disorder that poses therapeutic challenges. Mixed-type melasma usually does not respond to conventional monotherapy.
  
  
  OBJECTIVE
  To evaluate the effectiveness and safety of 1064-nm Q-switched neodymium-doped yttrium-aluminium-garnet laser (1064 QNYL) and 30% glycolic acid (GA) peel in the treatment of melasma.
  
  
  METHODS
  This was a split-face study, in which 16 patients were treated with 1064 QNYL (6-mm spot size, 2.0-2.3 J/cm(2) fluence) for six sessions at 1-week intervals to the entire face, and with GA for three sessions at 2-week intervals to the experimental side of the face. Clinical evaluations, measurements on a pigment measuring device (Mexameter), and assessment of patient satisfaction and adverse events were performed at baseline and every visit.
  
  
  RESULTS
  After treatment, significant improvements from baseline were seen in Mexameter and modified Melasma Area and Severity Index (mMASI) on both sides of the face. The combined therapy side achieved an average 32.6% improvement in Mexameter readings and 37.4% improvement in mMASI, compared with 22% and 16.7%, respectively, on the side treated with laser only (P ≤ 0.05). Both the physician and patient assessments correlated with the Mexameter results and mMASI.
  
  
  CONCLUSIONS
  Combined 1064 QNYL and GA seems to be superior to 1064 QNYL alone in the treatment of mixed-type melasma.
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea.
authors.forename: K Y
authors.initials: KY
authors.lastname: Park
authors.forename: D H
authors.initials: DH
authors.lastname: Kim
authors.forename: H K
authors.initials: HK
authors.lastname: Kim
authors.forename: K
authors.initials: K
authors.lastname: Li
authors.forename: S J
authors.initials: SJ
authors.lastname: Seo
authors.forename: C K
authors.initials: CK
authors.lastname: Hong
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006016:Glycolates / Q000627:therapeutic use*; D006801:Humans; D007641:Keratolytic Agents / Q000627:therapeutic use*; D007723:Korea; D053844:Lasers, Solid-State; D008297:Male; D008548:Melanosis / Q000628:therapy*; D008875:Middle Aged; D009354:Neodymium; D017060:Patient Satisfaction; D011446:Prospective Studies; D012720:Severity of Illness Index; D012880:Skin Pigmentation / Q000187:drug effects / Q000528:radiation effects; D015019:Yttrium
chemical_list: D006016:Glycolates; D007641:Keratolytic Agents; C031149:glycolic acid; D009354:Neodymium; D015019:Yttrium