Treatment of Laser-Responsive Dermal Pigmentary Conditions in Type III-IV Asian Skin with a 755-nm Picosecond Pulse Duration Laser: A Retrospective Review of Its Efficacy and Safety

Abstract

BACKGROUNDPicosecond lasers have become very popular in the treatment of hyperpigmentation.OBJECTIVEEvaluating the efficacy and safety of picosecond 755-nm laser in treatment of nevi of Ota (NO) and Hori's nevi (HN) in Asians with Fitzpatrick skin Types III/IV.METHODSA retrospective review of patient records at the National Skin Center, Singapore, from 2015 to 2017. Three independent blinded dermatologists assessed pre-and-post treatment photographs using the physician's global assessment (PGA) score (0-clear, 1-almost clear, 2-mild, 3-moderate, and 4-severe).RESULTSThere were 18 cases of NO and 11 cases of HN. Mean treatment sessions were 2.22 (NO; range 1-6) and 3.82 (HN; range 1-6). In the NO group, mean pre-and-post treatment PGA scores were 3.1 and 1.3, respectively (1.8 point change, p-value 0.0002), and average fluence used was 2.02 J/cm2(range: 1.02-2.38). In the HN group, mean pre-and-post treatment PGA scores were 2.6 and 1.1, respectively (1.5 point change, p-value 0.004), and average fluence was 2.08 J/cm2(range: 1.98-3.40). Eleven patients (37.9%) experienced postlaser erythema, and 1 (3.4%) patient developed transient postlaser hypopigmentation. No permanent hyper/hypopigmentation was seen.CONCLUSIONThe picosecond 755-nm laser is effective in the treatment of dermal pigmentary conditions in Asians with Fitzpatrick skin Types III/IV, with minimal risk of postlaser complications, and compared with the center's past experience with the Q-switched nanosecond 1064-nm laser, results in faster and more effective pigment clearance.