title: Treatment of melasma in men with low-fluence Q-switched neodymium-doped yttrium-aluminum-garnet laser versus combined laser and glycolic acid peeling.
abstract: BACKGROUND
  Low-fluence Q-switched neodymium-doped yttrium-aluminum-garnet 1,064-nm laser (LFQS) and glycolic acid (GA) peeling have been reported as a treatment option for melasma. However, there are limited data on their efficacy in men.
  
  
  OBJECTIVE
  To compare the efficacy and safety of LFQS monotherapy with combined LFQS and 30% GA peeling in male patients with melasma.
  
  
  METHODS
  Fifteen males with mixed type melasma were randomized to receive 5 weekly sessions of LFQS on one side of the face and LFQS plus 30% GA peeling on the contralateral side and were followed for 12 weeks. Twelve patients completed the protocol.
  
  
  RESULTS
  Mean relative lightness index (RL*I) of the combined treatment side was lowered throughout the study period, with the maximal improvement of 52.3% reduction at the fourth week follow-up (p = .023). Patient self-assessment was favorable in the combined treatment. However, the mean RL*I increased at 8 and 12 weeks of follow-up. One subject (8.3%) developed guttate hypopigmentation, which did not resolve by the 12-week follow-up.
  
  
  CONCLUSIONS
  Low-fluence Q-switched neodymium-doped yttrium-aluminum-garnet 1,064-nm laser combined with GA peeling temporarily reduced melasma in men, but the incidence of side effects does not justify the short-lived benefits of this procedure. This technique requires further study.
authors.affiliation: *Ramathibodi Laser Center, Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; and †Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand.
authors.forename: Vasanop
authors.initials: V
authors.lastname: Vachiramon
authors.forename: Sinijchaya
authors.initials: S
authors.lastname: Sahawatwong
authors.forename: Punyaphat
authors.initials: P
authors.lastname: Sirithanabadeekul
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy / Q000379:methods; D005500:Follow-Up Studies; D006016:Glycolates / Q000008:administration & dosage*; D006801:Humans; D007641:Keratolytic Agents / Q000008:administration & dosage; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D008548:Melanosis / Q000188:drug therapy* / Q000532:radiotherapy*; D008875:Middle Aged; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D006016:Glycolates; D007641:Keratolytic Agents; C031149:glycolic acid