title: A prospective, split-face, double-blinded, randomized study of the efficacy and safety of a fractional 1064-nm Q-switched Nd:YAG laser for photoaging-associated mottled pigmentation in Asian skin.
abstract: BACKGROUND
  Laser toning using low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminum laser (QSNY) has gained popularity in the treatment of photoaging-associated mottled pigmentation (PMP). However, hypopigmentation or lack of efficacy has been reported depending on the fluences used.
  
  
  OBJECTIVE
  To compare a novel fractional 1064-nm QSNY with conventional 1064-nm QSNY for the treatment of photoaging-associated mottled pigmentary lesions except epidermal lesions of lentigines and freckles through a randomized, split-face, double-blind study.
  
  
  METHODS
  Thirteen Asian women were treated every week for 6 weeks with fractional 1064-nm QSNY on one side of the face and conventional 1064-nm QSNY on the other side. We evaluated the pigmentation area and severity index (PSI), melanin index, erythema index, and the patient's global assessment of improvement.
  
  
  RESULTS
  At three months post-treatment, the PSI score improved compared with baseline, by 14.48% on the conventional 1064-nm QSNY side and 21.81% on the fractional 1064-nm QSNY side. Both groups showed improvements in the melanin index.
  
  
  CONCLUSIONS
  Both fractional 1064-nm QSNY and strictly low-fluence conventional 1064-nm QSNY are moderately effective against PMP and other photoaging signs. Fractional laser toning shows better subjective outcomes than conventional toning.
authors.affiliation: a Department of Dermatology , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Korea.
authors.forename: Kwang Hee
authors.initials: KH
authors.lastname: Won
authors.affiliation: a Department of Dermatology , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Korea.
authors.forename: Sang Hyung
authors.initials: SH
authors.lastname: Lee
authors.affiliation: a Department of Dermatology , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Korea.
authors.forename: Mi Hye
authors.initials: MH
authors.lastname: Lee
authors.affiliation: b Leaders Dermatologic Clinic , Seoul , Korea.
authors.forename: Do-Young
authors.initials: DY
authors.lastname: Rhee
authors.affiliation: c Jongno S and U Dermatologic Clinic , Seoul , Korea.
authors.forename: Un-Cheol
authors.initials: UC
authors.lastname: Yeo
authors.affiliation: a Department of Dermatology , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Korea.
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Chang
mesh_terms: D000328:Adult; D044466:Asian People; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D016110:Epidermolysis Bullosa Simplex / Q000628:therapy*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D028022:Low-Level Light Therapy / Q000379:methods*; D017060:Patient Satisfaction; D011446:Prospective Studies; D013472:Sunlight / Q000009:adverse effects*; D016896:Treatment Outcome
keywords: Associated mottled pigmentation (PMP); fractional 1064-nm Q-switched Nd:YAG laser; photoaging