{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:53:29Z","timestamp":1790952809378,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,7,12]],"date-time":"2020-07-12T00:00:00Z","timestamp":1594512000000},"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":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Melasma is a common skin disorder. Nd:YAG laser toning is a popular treatment for melanin clearance. Treatment efficacy is limited by factors such as presence of reactive oxygen species, DNA damage, TEWL, and skin barrier disruption.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The purpose of this pilot study is to explore the efficacy of a non\u2010crosslinked hyaluronic acid with anti\u2010oxidant ingredients in mitigating the above\u2010stated factors in the treatment of melasma using Nd:YAG laser toning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>In this pilot retrospective study of six cases with melasma, Nd:YAG laser toning was performed for each case until improvement of melasma has plateaued (after 4\u20106 sessions) and at which point treatment was paused. After injecting non\u2010crosslinked hyaluronic acid (9\u201012\u00a0mL) with anti\u2010oxidant ingredients into the face with focus on the lesional skin, further sessions (4\u20106) of Nd:YAG laser toning was resumed. Before, interim (improvement has plateaued), and after (on completion of the remaining sessions of laser toning after hyaluronic acid injection) photos of the six cases were scored using modified MASI. ANOVA analysis was applied to the scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All six melasma cases had further improvement in melasma clearance after hyaluronic acid injection beyond the point when improvement has plateaued. ANOVA analysis of before, interim, and after scores showed statistical significance in difference between the three groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This pilot study of six cases suggests that the use of a non\u2010crosslinked hyaluronic acid with anti\u2010oxidants may improve the efficacy of Nd:YAG laser toning in the treatment of melasma.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.13565","type":"journal-article","created":{"date-parts":[[2020,6,25]],"date-time":"2020-06-25T21:32:05Z","timestamp":1593120725000},"page":"2212-2218","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A pilot study on the use of a non\u2010crosslinked hyaluronic acid with associated anti\u2010oxidant ingredients to improve the effectiveness of Nd:YAG laser toning in the treatment of melasma in six patients"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6548-3870","authenticated-orcid":false,"given":"Daniel LK","family":"Yip","sequence":"first","affiliation":[{"name":"Department of Family Practice Faculty of Medicine University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.12911"},{"issue":"4","key":"e_1_2_8_3_1","first-page":"s135","article-title":"Laser treatment of skin of color for medical and aesthetic uses with a new 650\u2010microsecond Nd:YAG 1064nm laser","volume":"18","author":"Roberts WE","year":"2019","journal-title":"J Drugs Dermatol"},{"issue":"3","key":"e_1_2_8_4_1","first-page":"s112","article-title":"Hyperpigmentation disorders in Hispanic population in the United States","volume":"18","author":"Rendon 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