Efficacy of the combination of Q‐switched Nd:YAG laser and microneedling for melasma

Abstract

Melasma is a common, multifactorial, and recurring disease which is not easy to treat. The purpose of this study is to evaluate the efficacy of microneedling in combination with Q-switched neodymium-doped yttrium aluminum garnet laser (QsNd-YAG laser) for treatment of melasma. Fifteen female patients with epidermal or mixed-type melasma on the face were included in the study. Patients were first treated with QsNd-YAG laser, and then with microneedling containing mesotherapy products of biomimetic peptides, at the same session. Modified Melasma Area Severity Index (mMASI) scores were calculated before the first session and again 2weeks after the last session. The same treatment protocol was repeated every 2weeks for five sessions within period of 3months of therapy. The evaluation was performed according to the before and after photographs taken from three angles including 90-degree front and 45 degrees from left and right with the VISIA device. Of the 15 patients included in the study, the mean mMASI scores before and after treatment were 9.2±5.7 (3.8-23.1) and 3.6±4.0 (0.6-16.8), respectively. mMASI scores were significantly reduced after completion of the protocol. Six (40%) patients had "very good response," 4 (26.7%) patients had "good response," and 5 (33.3%) patients were "unresponsive." Six (40%) patients were followed up for 1year, and only 1 patient had a recurrence (6.7%). In addition to the use of photoprotective measures, multimodality treatment including QsNd-YAG laser and microneedling with mesotherapy products containing biomimetic peptides is effective to treat melasma and they work synergistically.