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Low\u2010fluence, multipass technique with Q\u2010switched\u2010mode laser\u2014\u201claser toning\u201d is broadly used to treat melasma, especially in Asia. The study aimed to evaluate the effects of a series of laser treatments with very short, nanosecond pulses in the treatment of melasma in Caucasian women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>Forty polish females with Fitzpatrick skin phototype II\u2013III and melasma were treated with 1064\u2009nm Q\u2010switched neodymium:yttrium\u2010aluminum\u2010garnet (QSNY) laser (pulse with 5\u2009ns; spot size, 6\u20138\u2009mm; fluence, 1.7\u20133.2\u2009J\/cm<jats:sup>2<\/jats:sup>; 2\u20138 passes; nine treatments). Melanin index (MI), erythema index (EI) by Mexameter MX18\u00ae, the modified Melasma Area Severity Index (mMASI), and the participant's self\u2010assessment were used to evaluate the treatment results. Twenty\u2010one patients were subjected to a 1\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant improvement in melasma pigmentation was observed in the mean MI and mMASI score; both were significantly reduced (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Significant erythema reduction was achieved (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In total, 70% of participants rated the laser as a method that met their expectations for treating melasma. Clinical follow\u2010up after one year showed that the reduced melasma effect was still maintained. Patients also noticed improved skin conditions (radiance, smoothness, brightness, hydration, regeneration). No serious adverse effects were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Low\u2010fluence 1064\u2009nm QSNY laser is an effective, safe, and noninvasive method with long\u2010term results in melasma treatment. QSNY (1064\u2009nm) improves the condition of melasma patients with erythema.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.23474","type":"journal-article","created":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T13:30:37Z","timestamp":1630589437000},"page":"366-373","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Treatment of melasma with a low\u2010fluence 1064\u2009nm Q\u2010switched Nd:YAG laser: Laser toning in Caucasian women"],"prefix":"10.1002","volume":"54","author":[{"given":"Iwona","family":"Micek","sequence":"first","affiliation":[{"name":"Department and Division of Practical Cosmetology and Skin Diseases Prophylaxis Poznan University of Medical Sciences  Poznan Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariola","family":"Pawlaczyk","sequence":"additional","affiliation":[{"name":"Department and Division of Practical Cosmetology and Skin Diseases Prophylaxis Poznan 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