Updated: Jan 5
from laser of Cutaneous and Aesthetic Surgery June 2012 Volume 5 Issue 2
Q Switch ND YAG for melasma
The most widely use for Melasma treatment
Low Dose Q Switch ND YAG for melasma treatment by these mechanism
induce sub-lethal injury causing fragmentation and rupture of melanin granule to cytoplasm
subcellular damage to the upper dermal vascular plexus which is one of the pathogenetic factors in melasma
subthreshold injury to the surrounding dermis stimulates the formation of collagen resulting in brighter and tighter skin
“laser toning” Technique
large spot size (6-8 mm)
low fluence (1.6-3.5 J/cm 2 )
multiple passed QS 1064 nm Nd:YAG laser
performed every 1-2 weeks for several weeks.
laser toning complication reported
While few studies document good efficacy with this Technique, several others have found hypopigmentation and depigmentation after a series of laser toning.
other reported complication
physical urticaria, acneiform eruption
and herpes simplex reactivation
cause of hypopigentation for laser toning technique
high fluences causing direct phototoxicity and cellular destruction of melanocyte
subthreshold additive effect of multiple doses
intrinsic unevenness of skin pigmentation
non-uniform laser energy output.
suggestion to avoid serious side effect
should be avoid
too many (>6-10)
too frequent (every week) laser sessions
Hypopigmentation should be looked for after every session and further treatments should be stopped.