{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:52:10Z","timestamp":1790952730464,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"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":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Picosecond lasers (PSL) are increasingly used for treating melasma, with fewer adverse effects reported compared to Q\u2010switched lasers (QSL). However, the incidence of hypopigmentation following PSL treatment remains unexplored in detail. This case series aims to explore outcomes of hypopigmentation following PSL therapy in patients with melasma, and explore potential contributing factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective chart review identified four patients with hypopigmentation following PSL treatment for melasma, including one referral from another clinic. Across the cohort, 796 patients underwent 3096 sessions between 2021 and 2025. Treatments used 755 and\/or 1064\u2010nm wavelengths at low fluences, with intervals of 4\u201312 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three in\u2010clinic patients (0.38%, 95% CI 0.13%\u20131.10%) and one referral developed hypopigmentation. Changes occurred across both wavelengths and beam profiles. Histology demonstrated preserved melanocyte density with reduced melanin pigment and melanosome content. None of the cases showed meaningful re\u2010pigmentation at 6\u2010month follow\u2010up. No cases of post\u2010inflammatory hyperpigmentation (PIH) were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While hypopigmentation is rare with PSL treatment, it can occur even with conservative low\u2010fluence settings and adequate intervals between sessions. One possible mechanism is thermal beam\u2010 stacking, where slow hand movement during treatment may lead to repeated pulses on the same area. This can result in localised thermal accumulation, potentially causing subcellular disruption of melanosomes without overt melanocyte loss. These findings suggest the need for clinician vigilance in monitoring for hypopigmentation, as re\u2010pigmentation may not be achievable. Larger, controlled studies are needed to clarify risk factors and guide safer practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lsm.70077","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T06:47:14Z","timestamp":1763362034000},"page":"777-787","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Hypopigmentation Following Picosecond Laser Treatment for Melasma: A Case Series"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1818-0543","authenticated-orcid":false,"given":"Xiaozhun","family":"Hang","sequence":"first","affiliation":[{"name":"Mowbray Park Medical and Dermatology Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davin Sui","family":"Lim","sequence":"additional","affiliation":[{"name":"Cutis Clinic, Dermatology Indooroopilly  Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,16]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20143063"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.2165\/00044011-199500102-00006"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.713554"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/JCAS.JCAS_179_18"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58070936"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13072116"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.22735"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/14764172.2017.1376098"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15934"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.23312"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.23615"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/09546634.2022.2033674"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000004393"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-020-02959-7"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000002612"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.18822"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1983.03330370053031"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.20956"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1524-4725.2001.00348.x"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.1999.02911.x"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2012.04473.x"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.16569"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1364\/AO.32.002447"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.5978\/islsm.20-OR-08"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijdvl.IJDVL_1086_16"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2012.02397.x"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.4103\/ds.ds_2_22"}],"container-title":["Lasers in Surgery and Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lsm.70077","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T03:53:41Z","timestamp":1765338821000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lsm.70077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,16]]},"references-count":27,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/lsm.70077"],"URL":"https:\/\/doi.org\/10.1002\/lsm.70077","archive":["Portico"],"relation":{},"ISSN":["0196-8092","1096-9101"],"issn-type":[{"value":"0196-8092","type":"print"},{"value":"1096-9101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,16]]},"assertion":[{"value":"2025-06-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}