A comparative study of low-fluence 1,064 nm Q-Switched Nd:YAG laser with or without chemical peeling using Jessner's solution in melasma patients.
BACKGROUND
Although low-fluence 1,064-nm Q-switched Nd:YAG laser (QSNYL) is widely used for the treatment of melasma, multiple treatments are necessary for clinical improvement. Superficial chemical peeling using Jessner's solution has been used for treatment of melasma conventionally.


OBJECTIVE
To evaluate the additional therapeutic effect and adverse effects of Jessner's peel when combined with 1,064 nm QSNYL for melasma patients in a double-blind, placebo-controlled design.


METHODS
Total of 52 patients were included. Patients who received 10 sessions of 1,064 nm QSNYL plus chemical peeling with placebo (Group A) in a two-week intervals and those who received 10 sessions of 1,064 nm QSNYL plus chemical peeling with Jessner's solution (Group B) in a 2-week intervals were analyzed. Responses were evaluated using the Melasma Area and Severity Index (MASI) score, physician's global assessment (PGA) and subjective self-assessment.


RESULTS
At 8 weeks, the mean MASI score decreased from 8.68 ± 4.06 to 8.60 ± 3.88 in Group A and from 8.98 ± 3.72 to 7.13 ± 2.57 in Group B, showing a significant difference (p < 0.001). But at 20 weeks, there was no significant difference on reduction of MASI, self-assessment, and PGA between the two groups. No serious adverse effects were reported with the additional Jessner's peeling.


CONCLUSIONS
This study suggests Jessner's peel is a safe and effective method in the early course of treatment for melasma, when combined with low-fluence 1,064-nm QSNYL.
Department of Dermatology, Ulsan University Hospital , Ulsan , Republic of Korea.
Dan Bi
DB
Lee
Ho Seok
HS
Suh
Yu Sung
YS
Choi
D044466:Asian People; D002615:Chemexfoliation / Q000379:methods*; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D004338:Drug Combinations; D000431:Ethanol / Q000627:therapeutic use*; D006801:Humans; D019344:Lactic Acid / Q000627:therapeutic use*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D028022:Low-Level Light Therapy / Q000379:methods*; D008548:Melanosis / Q000628:therapy*; D017060:Patient Satisfaction; D012118:Resorcinols / Q000627:therapeutic use*; D012459:Salicylates / Q000627:therapeutic use*
D004338:Drug Combinations; C061170:Jessner's solution; D012118:Resorcinols; D012459:Salicylates; D019344:Lactic Acid; D000431:Ethanol
Jessner's solution; low-fluence 1,064 nm Q-switched Nd:YAG; melasma