{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T12:57:19Z","timestamp":1774184239641,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T00:00:00Z","timestamp":1662681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Conventional high fluence Q\u2010switched (HFQS) Alexandrite 755\u2010nm are widely used in clinical caf\u00e9\u2010au\u2010lait macules (CALMs) treatment. There have been recent concerns regarding the efficacy and safety of low fluence Q\u2010switched (LFQS) Nd: YAG 1064\u2010nm lasers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the efficacy and safety of the conventional HFQS and LFQS laser in the treatment of CALMs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Within 3 months, 20 patients underwent prospective self\u2010controlled split\u2010lesion treatments with HFQS once or twice depending on the recovery rate, and with LFQS six times biweekly. Then the more effective laser was selected for continued treatments. Efficacy outcomes were evaluated by a visual analog scale (VAS) biweekly during the comparative trail. Recovery process, side effects and recurrence were recorded during the trial and follow\u2010up visit. Patient and physician preferences for laser selection were also recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The average VAS scores of areas treated with HFQS and LFQS were 2.92\u2009\u00b1\u20090.86 and 2.93\u2009\u00b1\u20091.13, respectively\u00a0(<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). The most significant efficacy change of LFQS was after the fourth laser treatment (VAS score: 1.82\u22122.37, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). 11\u00a0lesions treated with LFQS and 7 with HFQS achieved an optimal treatment response (3.67\u2009\u2264\u2009VAS\u2009\u2264\u20094). Three patients relapsed on one side (one on LFQS, two on HFQS) and five on both sides. Adverse effects included temporary hypopigmentation, hyperpigmentation, uneven pigmentation, and mottled hypopigmentation. Doctors thought 80% of patients were suitable for LFQS. 70% of patients preferred LFQS posttreatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The efficacy difference between the LFQS 1064\u2010nm laser and HFQS 755\u2010nm laser in treating CALMs in a 3\u2010month comparative trial was statistically insignificant. LFQS is preferred by doctors and patients and is likely to help more patients achieve treatment efficacy than the HFQS within a short time, with fewer temporary adverse reactions, and a more even pigmentation. But it can cause mottled hypopigmentation.\u00a0The LFQS had obvious lesion clearance after the fourth treatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.23594","type":"journal-article","created":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T21:38:12Z","timestamp":1662759492000},"page":"1051-1059","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of the safety and efficacy of low fluence Q\u2010switched 1064\u2010nm and conventional Q\u2010Switched 755\u2010nm lasers in the treatment of caf\u00e9\u2010au\u2010lait macules: A prospective self\u2010controlled trial"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2590-0147","authenticated-orcid":false,"given":"Qingqing","family":"Cen","sequence":"first","affiliation":[{"name":"Department of Laser and Aesthetic Medicine, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China"},{"name":"Department of Plastic and Reconstructive Surgery, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0805-5757","authenticated-orcid":false,"given":"Jiafang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Laser and Aesthetic Medicine, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7245-101X","authenticated-orcid":false,"given":"Lucia","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenxin","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Laser and Aesthetic Medicine, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianglei","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Laser and Aesthetic Medicine, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Laser and Aesthetic Medicine, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Laser and Aesthetic Medicine, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China"},{"name":"Department of Plastic and Reconstructive Surgery, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lan","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoxi","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Laser and Aesthetic Medicine, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China"},{"name":"Department of Plastic and Reconstructive Surgery, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,9,9]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"1025","volume-title":"Dermatology essentials","author":"Bolognia J","year":"2014"},{"key":"e_1_2_9_3_1","unstructured":"JhaSK MendezMD.Cafe Au Lait Macules.StatPearls. 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