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Research Paper | Dermatology | India | Volume 12 Issue 11, November 2023

A Combination of Low-Fluence (1064 nm) Q-SNd: Yag Laser with Topical 2% Hydroquinone Cream v/s Topical 2% Hydroquinone Cream for Melasma in Indians-Randomised Controlled Trial

Dr. Snehal M. Navande | Dr. Amit Kelkar | Vidyadhar R. Sardesai

Abstract: Context: Long term treatment, unpredictable results and recurrence necessitate search for new modalities of treatment of melasma. Aims: To compare the efficacy and side effect of combination (Q-S Nd-YAG laser + 2% hydroquinone cream) with topical 2% hydroquinone cream alone for melasma in Indians. Settings and Design: A prospective, comparative and interventional study with split face design randomized control study was conducted in the Dermatology Department of a Teaching hospital and a Tertiary Care Centre, in Pune for 18 months. Methods and Material: 30 patients with dermal or mixed?type melisma (Wood?s Lamp examination) were enrolled for 10 weeks of study. One side of the face was treated with topical application of 2% hydroquinone cream alone and other side was treated with combination of 1,064?nm QS?Nd:YAG laser, 6?mm spot size, 1.5? to 1.7?J/cm2 fluence for four sessions at 1?week intervals and topical application of 2% hydroquinone cream. Evaluation was done by standard digital clinical photographs and Modified MASI score taken at 0, 6 and 10 weeks. Results: 63.6% sides treated with a combination vs. 31.8% sides treated with topical cream alone reported improvement. The combination therapy was significantly more effective than the topical treatment alone as per Chi-Square test (p=0.034). During follow?up, eight of 22 patients developed rebound hyperpigmentation of melasma. Conclusion: The Combination therapy is more effective than the Topical treatment alone in treatment of dermal and mixed melisma. However, the Combination does not show sustained results and has undesirable side effects and hence needs to be used with caution.

Keywords: Q-Switched Nd-YAG laser, Melasma, Hydroquinone cream, Hyperpigmentation

Edition: Volume 12 Issue 11, November 2023,

Pages: 851 - 855