title: Treatment of melasma using a novel 1,927-nm fractional thulium fiber laser: a pilot study.
abstract: BACKGROUND
  A 1,927-nm wavelength was recently added to the 1,550-nm erbium-doped fiber laser. This wavelength possesses a higher absorption coefficient for water than the 1,550-nm, conferring greater ability to target epidermal processes such as dyschromia.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of a novel 1,927-nm fractional thulium fiber laser in the treatment of melasma.
  
  
  METHODS
  Fourteen patients underwent three to four laser treatments (at 4-week intervals) at pulse energies of 10 to 20 mJ and total densities of 252 to 784 microscopic treatment zones per cm(2) (6-8 passes) using a 1,927-nm thulium fiber laser. Three blinded assessors and the patients evaluated clinical improvement of treatment areas at 1-, 3-, and 6-month follow-ups. Side effects were assessed, and pain was scored using a visual analog scale (0-10).
  
  
  RESULTS
  A statistically significant 51% reduction in MASI score was observed at 1-month post 3 to 4 laser treatments. A 33% (p = .06) and 34% (p = .07) reduction in Melasma Area and Severity Index score was observed at the 3- and 6-month follow-up visits, respectively. Skin responses observed after treatment were moderate erythema and mild edema. No scarring or postinflammatory hyper- or hypopigmentation was observed.
  
  
  CONCLUSIONS
  The 1,927-nm fractional thulium fiber laser is a safe, effective treatment for melasma.
authors.affiliation: Department of Dermatology, University of Texas at Houston, Houston, Texas, USA. kristelpolder@hotmail.com
authors.forename: Kristel D
authors.initials: KD
authors.lastname: Polder
authors.forename: Suzanne
authors.initials: S
authors.lastname: Bruce
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects; D053844:Lasers, Solid-State; D008297:Male; D008548:Melanosis / Q000628:therapy*; D008875:Middle Aged