Efficacy and safety of Q-switched Nd:YAG laser in the treatment of facial pigmentary lesions: A retrospective observational study

Background: The Q-switched neodymium: yttrium aluminum garnet laser (QS-Nd:YAG) is effective in the treatment of tattoos and different pigmentary conditions; however, little has been published regarding the removal of facial cutaneous pigmented lesions. The aim of this study was to determine the effectiveness and safety of QS-Nd:YAG laser in the treatment of facial pigmentary lesions in Indian patients. Methods: Data of 100 patients with pigmented facial lesions treated with QS-Nd:YAG laser were analyzed. Clinical improvement of skin lesions was assessed by the physician’s global assessment of two blinded observers. This was done based on photographs taken at the baseline and after the last treatment session. Side effects were recorded if present, and patient satisfaction was evaluated after each treatment session. Results: The majority of the patients had post-inflammatory hyperpigmentation (n=41), followed by melasma (n=19), photomelanosis (n=15), nevus of Ota (n=5), periorbital melanosis (n=5), nevus spilus (n=3), Riehl melanosis (n=3), Cafe-au-lait macules (n=2), freckles (n=2), lichen planus pigmentosus (n=2), compound nevus (n=1), Hori’s nevus (n=1), and pigmentary demarcation lines (n=1). 10% of patients showed more than 50% improvement in pigmentation from the baseline level; no response was seen in 22% of patients, while 7% experienced worsened pigmentation. Conclusion: The degree of improvement and efficacy in clearing pigmentation is partial, variable, and inconsistent. Worsening of pigmentation may be seen and needs to be discussed with the patient prior to treatment