Jang, H.W., Chun, S.H., Park, H.C., Ryu, H.J., Kim, I.H. (2017) Comparative study of dual-pulsed 1,064 nm Q-switched Nd:YAG laser and single-pulsed 1,064 nm Q-switched Nd:YAG laser by using zebrafish model and prospective split-face analysis of facial melasma. Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology. 19(2):114-123.
Background Recently dual-pulsed low-fluence 1064-nm Q-switched Nd:YAG (QSNY) laser has been developed for reducing complication during melasma treatment.
Objective Comparison of the efficacy and safety between dual-pulsed mode and single-pulsed mode for the treatment of melasma.
Materials and methods In preclinical study, adult zebrafish were irradiated with dual-pulsed and single-pulsed mode. Changes of melanophore and cell death were assessed. In split-face clinical study, dual-pulsed and single-pulsed mode were irradiated on the left and right side of the face, respectively. L* value, clinical digital photos, modified Melasma Area and Severity Index (MASI) scores, and side effects were measured.
Results As compared to single-pulsed mode and dual-pulsed mode with longer intervals, zebrafish melanophore was cleared quickly at dual-pulsed mode with 80-μsec interval and 0.3 J/cm2 fluence. Dual-pulsed mode showed the least regeneration of melanophore at 4 weeks after irradiation and no cell death was observed with 80-μsec interval. Both pulse modes improved melasma significantly but modified MASI score and L* value were not significantly different between each other. Lesser pain and shorter duration of post-laser erythema were observed with dual-pulsed mode.
Conclusion Dual-pulsed mode was as effective as single-pulsed mode for the treatment of melasma and revealed less side effects.