A comparative study of low-fluence Q-switched neodymium-doped: yttrium aluminum garnet laser versus 15% trichloroacetic acid peel in the treatment of melasma

Authors

  • Sridhar Venu Department of Dermatology, Chengalpattu Medical College, Chengalpattu, Tamil Nadu
  • Sarath Chandran Balachandar Department of Dermatology, Chengalpattu Medical College, Chengalpattu, Tamil Nadu
  • Kamalanathan Nallu Department of Dermatology, Chengalpattu Medical College, Chengalpattu, Tamil Nadu
  • C. Lakshmanan Department of Dermatology, Chengalpattu Medical College, Chengalpattu, Tamil Nadu

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20193221

Keywords:

Melasma, Trichloroacetic acid, Q-switched Nd, YAG laser, Post inflammatory hyperpigmentation

Abstract

Background: Melasma is an acquired, circumscribed, pigmentary disorder. It is characterized by more or less symmetrically distributed, dark brown macules with well-defined geographic borders and is often resistant to treatment. The aim of our study is to compare the therapeutic efficacy of low-fluence Q-switched neodymium-doped: yttrium aluminum garnet (Qs-Nd:YAG) laser versus 15% trichloroacetic acid (TCA) peel in the treatment of melasma.

Methods: Our study was an open, prospective, comparative study that included 50 melasma patients. They were then randomized into group 1 (n=25) and group 2 (n=25) by means of sequentially numbered list. Patients in group 1 were treated with 15% TCA. The procedure was repeated every two weeks for 6 times. Group 2 patients were treated with low influence Q-switched Nd:YAG laser. The treatment was given for four sittings at a gap of 3 weeks. Melasma area and severity index (MASI) was used to assess the response of therapy. Patients were followed up for 12 weeks after completing the study.

Results: The total percentage of reduction in mean MASI was 41.92% in group 1 and 27.88% in group 2 which was statistically significant (p=0.007). Post inflammatory hyper- pigmentation was the most common side effect in patients treated with Nd-YAG laser, particularly Fitzpatrick skin type V.

Conclusions: 15% TCA was better than Q switched Nd:YAG laser for the treatment of melasma. Qs-Nd:YAG laser is not an effective treatment option due to higher incidence of adverse effects.

Author Biographies

Sridhar Venu, Department of Dermatology, Chengalpattu Medical College, Chengalpattu, Tamil Nadu

Assistant Professor

Department of Dermatology Venereology & Leprosy

Chengalpattu Medical College & Hospital

Chengalpattu

Tamilnadu

India

 

Sarath Chandran Balachandar, Department of Dermatology, Chengalpattu Medical College, Chengalpattu, Tamil Nadu

Senior Resident

Department of Dermatology Venereology & Leprosy

Chengalpattu Medical College & Hospital

Chengalpattu

Tamilnadu

India

 

Kamalanathan Nallu, Department of Dermatology, Chengalpattu Medical College, Chengalpattu, Tamil Nadu

Assistant Professor

Department of Dermatology Venereology & Leprosy

Chengalpattu Medical College & Hospital

Chengalpattu

Tamilnadu

India

 

C. Lakshmanan, Department of Dermatology, Chengalpattu Medical College, Chengalpattu, Tamil Nadu

Junior Resident

Department of Dermatology Venereology & Leprosy

Chengalpattu Medical College & Hospital

Chengalpattu

Tamilnadu

India

 

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Published

2019-07-24

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Original Research Articles