{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:07:55Z","timestamp":1792793275521,"version":"4.5.0"},"reference-count":63,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,14]],"date-time":"2022-07-14T00:00:00Z","timestamp":1657756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Melasma is a common pigmentary disorder with a complex pathogenesis, of which the treatment is challenging. Conventional treatment often leads to inconsistent results with unexpected pigmentary side effects and high recurrence rates. Recently, the low-fluence Q-switched Nd:YAG laser (LFQSNY) has been widely used for treating melasma, especially in Asia. We reviewed literatures on the LFQSNY treatment of melasma published between 2009 and May 2022 to evaluate the efficacy and adverse events, including its combination therapy. A systematic PubMed search was conducted and a total of 42 articles were included in this study. It was hard to summarize the heterogenous studies, but LFQSNY appeared to be a generally effective and safe treatment for melasma considering the results of previous conventional therapies. However, mottled hypopigmentation has been occasionally reported to develop and persist as an adverse event of LFQSNY, which may be associated with the high accumulated laser energy. When used aggressively, even LFQSNY can induce hyperpigmentation via unwanted inflammation, especially in darker skin. Although few studies have reported considerable recurrence rates three months after treatment, unfortunately, there is a lack of the long-term follow-up results of LFQSNY in melasma. To enhance the effectiveness and reduce the adverse events, LFQSNY has been used in combination with other treatment modalities in melasma, including topical bleaching agents, oral tranexamic acid, chemical peeling, or diverse energy-based devices, which generally reduced side effects with or without significant superior efficacy compared to LFQSNY alone.<\/jats:p>","DOI":"10.3390\/medicina58070936","type":"journal-article","created":{"date-parts":[[2022,7,15]],"date-time":"2022-07-15T01:57:11Z","timestamp":1657850231000},"page":"936","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["The Low-Fluence Q-Switched Nd:YAG Laser Treatment for Melasma: A Systematic Review"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0455-3270","authenticated-orcid":false,"given":"Yeon Seok","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Dermatology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu Jin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Min","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0317-9635","authenticated-orcid":false,"given":"Tae Young","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"June Hyunkyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1215-7078","authenticated-orcid":false,"given":"Jae Eun","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1111\/exd.13844","article-title":"Melasma: Updates and perspectives","volume":"28","author":"Kwon","year":"2019","journal-title":"Exp. Dermatol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Ko, D., Wang, R.F., Ozog, D., Lim, H.W., and Mohammad, T.F. (J. Am. Acad. Dermatol., 2022). Disorders of Hyperpigmentation. Part II. Review of management and treatment options for hyperpigmentation, J. Am. Acad. Dermatol., in press.","DOI":"10.1016\/j.jaad.2021.12.065"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1080\/09546634.2021.1914313","article-title":"Melasma treatment: A systematic review","volume":"33","author":"Neagu","year":"2022","journal-title":"J. Dermatol. Treat."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2099","DOI":"10.1007\/s10103-022-03514-2","article-title":"Laser therapy in the treatment of melasma: A systematic review and meta-analysis","volume":"37","author":"Lai","year":"2022","journal-title":"Lasers Med. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1111\/pcmr.12684","article-title":"Melasma, a photoaging disorder","volume":"31","author":"Passeron","year":"2018","journal-title":"Pigment Cell Melanoma Res."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kwon, S.H., Hwang, Y.J., Lee, S.K., and Park, K.C. (2016). Heterogeneous Pathology of Melasma and Its Clinical Implications. Int. J. Mol. Sci., 17.","DOI":"10.3390\/ijms17060824"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.jdermsci.2007.01.009","article-title":"The vascular characteristics of melasma","volume":"46","author":"Kim","year":"2007","journal-title":"J. Dermatol. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1093\/jmicro\/dfq068","article-title":"A low fluence Q-switched Nd:YAG laser modifies the 3D structure of melanocyte and ultrastructure of melanosome by subcellular-selective photothermolysis","volume":"60","author":"Mun","year":"2011","journal-title":"J. Electron. Microsc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2333","DOI":"10.1038\/jid.2010.129","article-title":"Subcellular selective photothermolysis of melanosomes in adult zebrafish skin following 1064-nm Q-switched Nd:YAG laser irradiation","volume":"130","author":"Kim","year":"2010","journal-title":"J. Investig. Dermatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1111\/jocd.14110","article-title":"A review of combined treatments for melasma involving energy-based devices and proposed pathogenesis-oriented combinations","volume":"21","author":"Mehrabi","year":"2022","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e14927","DOI":"10.1111\/dth.14927","article-title":"The efficacy of energy-based devices combination therapy for melasma","volume":"34","author":"Iranmanesh","year":"2021","journal-title":"Dermatol. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1002\/lsm.23474","article-title":"Treatment of melasma with a low-fluence 1064\u2009nm Q-switched Nd:YAG laser: Laser toning in Caucasian women","volume":"54","author":"Micek","year":"2022","journal-title":"Lasers Surg. Med."},{"key":"ref_13","unstructured":"Hong, J.K., Shin, S.H., Park, S.J., Seo, S.J., and Park, K.Y. (2022). A prospective, split-face study comparing 1064-nm picosecond Nd:YAG laser toning with 1064-nm Q-switched Nd:YAG laser toning in the treatment of melasma. J. Dermatol. Treat., 1\u20137."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1002\/lsm.23440","article-title":"Efficacy and Safety of Topical Silymarin Versus Low Fluence 1064-nm Q Switched Nd:YAG Laser in the Treatment of Melasma: A Comparative Randomized Trial","volume":"53","author":"Ibrahim","year":"2021","journal-title":"Lasers Surg. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1002\/lsm.23441","article-title":"Combining Low Power Fractional CO2 With QS-NdYAG Toning in the Treatment of Melasma Reduces the Incidence of Punctate Leukoderma","volume":"53","author":"Esmat","year":"2021","journal-title":"Lasers Surg. Med."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Debasmita, B., Raj, C., Ishan, A., and Ipsita, D. (2021). A prospective randomized controlled trial of Q-switched Nd:YAG laser with topical 3% tranexamic acid (TA) versus microneedling with topical 3% tranexamic acid (TA) in treatment of melasma. J. Cosmet. Dermatol., 1\u20137.","DOI":"10.1111\/jocd.14532"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1080\/09546634.2019.1708847","article-title":"A comparative study between oral tranexamic acid versus oral tranexamic acid and Q-switched Nd-YAG laser in melasma treatment: A clinical and dermoscopic evaluation","volume":"32","author":"Agamia","year":"2021","journal-title":"J. Dermatol. Treat."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1111\/ijd.15229","article-title":"A split face randomized controlled trial comparing 1064 nm Q-switched Nd-YAG laser and modified Kligman\u2019s formulation in patients with melasma in darker skin","volume":"59","author":"Dev","year":"2020","journal-title":"Int. J. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1080\/09546634.2018.1516858","article-title":"Combined treatment of melasma involving low-fluence Q-switched Nd:YAG laser and fractional microneedling radiofrequency","volume":"30","author":"Kwon","year":"2019","journal-title":"J. Dermatol. Treat."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"133","DOI":"10.5021\/ad.2019.31.2.133","article-title":"A Face-Split Study to Evaluate the Effects of Microneedle Radiofrequency with Q-Switched Nd:YAG Laser for the Treatment of Melasma","volume":"31","author":"Jung","year":"2019","journal-title":"Ann. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1111\/jocd.12760","article-title":"Low-fluence Q-switched Nd:YAG laser for the treatment of melasma in Asian patients","volume":"17","author":"Choi","year":"2018","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5021\/ad.2018.30.1.1","article-title":"Treatment of Melasma with Pulsed-Dye Laser and 1064-nm Q-Switched Nd:YAG Laser: A Split-Face Study","volume":"30","author":"Kong","year":"2018","journal-title":"Ann. Dermatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1111\/jocd.12444","article-title":"Q-switched Nd: YAG laser alone or with modified Jessner chemical peeling for treatment of mixed melasma in dark skin types: A comparative clinical, histopathological, and immunohistochemical study","volume":"17","author":"Saleh","year":"2018","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1097\/DSS.0000000000001120","article-title":"The Clinical and Histological Effect of a Low-Fluence Q-Switched 1064-nm Neodymium: Yttrium-Aluminum-Garnet Laser for the Treatment of Melasma and Solar Lentigenes in Asians: Prospective, Randomized, and Split-Face Comparative Study","volume":"43","author":"Kaminaka","year":"2017","journal-title":"Dermatol. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15171\/jlms.2017.01","article-title":"Combination of Q-Switched Nd:YAG and Fractional Erbium:YAG Lasers in Treatment of Melasma: A Randomized Controlled Clinical Trial","volume":"8","author":"Alavi","year":"2017","journal-title":"J. Lasers Med. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1080\/14764172.2016.1262958","article-title":"Comparative study of dual-pulsed 1064 nm Q-switched Nd:YAG laser and single-pulsed 1064 nm Q-switched Nd:YAG laser by using zebrafish model and prospective split-face analysis of facial melasma","volume":"19","author":"Jang","year":"2017","journal-title":"J. Cosmet. Laser Ther."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1111\/jocd.12253","article-title":"Long-term results in low-fluence 1064-nm Q-Switched Nd:YAG laser for melasma: Is it effective?","volume":"15","author":"Gokalp","year":"2016","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1097\/DSS.0000000000000653","article-title":"Clinical and Histopathologic Assessment of Facial Melasma After Low-Fluence Q-Switched Neodymium-Doped Yttrium Aluminium Garnet Laser","volume":"42","author":"Careta","year":"2016","journal-title":"Dermatol. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1097\/DSS.0000000000000304","article-title":"Treatment of melasma in men with low-fluence Q-switched neodymium-doped yttrium-aluminum-garnet laser versus combined laser and glycolic acid peeling","volume":"41","author":"Vachiramon","year":"2015","journal-title":"Dermatol. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2","DOI":"10.3109\/14764172.2014.957217","article-title":"Retrospective analysis of melasma treatment using a dual mode of low-fluence Q-switched and long-pulse Nd:YAG laser vs. low-fluence Q-switched Nd:YAG laser monotherapy","volume":"17","author":"Choi","year":"2015","journal-title":"J. Cosmet. Laser Ther."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"129","DOI":"10.3109\/14764172.2014.988730","article-title":"Retreatment using a dual mode of low-fluence Q-switched and long-pulse Nd:YAG laser in patients with melasma aggravation after previous therapy","volume":"17","author":"Choi","year":"2015","journal-title":"J. Cosmet. Laser Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1097\/DSS.0000000000000057","article-title":"Combination treatment of low-fluence 1064-nm Q-switched Nd: YAG laser with novel intense pulse light in Korean melasma patients: A prospective, randomized, controlled trial","volume":"40","author":"Yun","year":"2014","journal-title":"Dermatol. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1002\/lsm.22303","article-title":"A split face study to document the safety and efficacy of clearance of melasma with a 5 ns q switched Nd YAG laser versus a 50 ns q switched Nd YAG laser","volume":"46","author":"Alsaad","year":"2014","journal-title":"Lasers Surg. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1002\/lsm.22263","article-title":"A randomized, split-face clinical trial of low-fluence Q-switched neodymium-doped yttrium aluminum garnet (1064 nm) laser versus low-fluence Q-switched alexandrite laser (755 nm) for the treatment of facial melasma","volume":"46","author":"Fabi","year":"2014","journal-title":"Lasers Surg. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"212","DOI":"10.3109\/09546634.2012.735639","article-title":"Treatment of melasma by low-fluence 1064 nm Q-switched Nd:YAG laser","volume":"25","author":"Sim","year":"2014","journal-title":"J. Dermatol. Treat."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"523","DOI":"10.3109\/09546634.2013.848261","article-title":"A comparative study of low-fluence 1064-nm Q-switched Nd:YAG laser with or without chemical peeling using Jessner\u2019s solution in melasma patients","volume":"25","author":"Lee","year":"2014","journal-title":"J. Dermatol. Treat."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1111\/dsu.12060","article-title":"Oral Tranexamic Acid Enhances the Efficacy of Low-Fluence 1064-Nm Quality-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser Treatment for Melasma in Koreans: A Randomized, Prospective Trial","volume":"39","author":"Shin","year":"2013","journal-title":"Dermatol. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"112","DOI":"10.3109\/09546634.2011.593487","article-title":"Better clinical results with long term benefits in melasma patients","volume":"24","author":"Na","year":"2013","journal-title":"J. Dermatol. Treat."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"143","DOI":"10.3109\/14764172.2013.769274","article-title":"A split-face comparison of low-fluence Q-switched Nd: YAG laser plus 1550 nm fractional photothermolysis vs. Q-switched Nd: YAG monotherapy for facial melasma in Asian skin","volume":"15","author":"Kim","year":"2013","journal-title":"J. Cosmet. Laser Ther."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"267","DOI":"10.5021\/ad.2012.24.3.267","article-title":"Intense Pulsed Light and Low-Fluence Q-Switched Nd:YAG Laser Treatment in Melasma Patients","volume":"24","author":"Na","year":"2012","journal-title":"Ann. Dermatol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.sder.2012.02.002","article-title":"The evolution of melasma therapy: Targeting melanosomes using low-fluence Q-switched neodymium-doped yttrium aluminium garnet lasers","volume":"31","author":"Kauvar","year":"2012","journal-title":"Semin. Cutan. Med. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"266","DOI":"10.4103\/0974-2077.104915","article-title":"A Comparison of Low-Fluence 1064-nm Q-Switched Nd: YAG Laser with Topical 20% Azelaic Acid Cream and their Combination in Melasma in Indian Patients","volume":"5","author":"Bansal","year":"2012","journal-title":"J. Cutan. Aesthetic Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1111\/j.1524-4725.2011.02001.x","article-title":"Efficacy and Safety of Q-Switched 1064-nm Neodymium-Doped Yttrium Aluminum Garnet Laser Treatment of Melasma","volume":"37","author":"Xi","year":"2011","journal-title":"Dermatol. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3109\/09546631003686051","article-title":"Efficacy of the 1064-nm Q-switched Nd:YAG laser in melasma","volume":"22","author":"Suh","year":"2011","journal-title":"J. Dermatol. Treat."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1111\/j.1365-2230.2011.04150.x","article-title":"A randomized, observer-blinded, comparison of combined 1064-nm Q-switched neodymium-doped yttrium\u2013aluminium\u2013garnet laser plus 30% glycolic acid peel vs. laser monotherapy to treat melasma","volume":"36","author":"Park","year":"2011","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"165","DOI":"10.4103\/0378-6323.93633","article-title":"A comparative study on efficacy of high and low fluence Q-switched Nd:YAG laser and glycolic acid peel in melasma","volume":"78","author":"Kar","year":"2011","journal-title":"Indian J. Dermatol. Venereol. Leprol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"189","DOI":"10.5978\/islsm.20.189","article-title":"The dual toning technique for melasma treatment with the 1064 Nd:YAG laser: A preliminary study","volume":"20","author":"Kang","year":"2011","journal-title":"Laser Ther."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"280","DOI":"10.3109\/14764172.2011.630084","article-title":"Treatment of melasma with low fluence, large spot size, 1064-nm Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for the treatment of melasma in Fitzpatrick skin types II-IV","volume":"13","author":"Brown","year":"2011","journal-title":"J. Cosmet. Laser Ther."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/j.1524-4725.2009.01383.x","article-title":"Low-fluence Q-switched neodymium-doped yttrium aluminum garnet (1064 nm) laser for the treatment of facial melasma in Asians","volume":"36","author":"Wattanakrai","year":"2010","journal-title":"Dermatol. Surg."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"126","DOI":"10.3109\/14764172.2010.487910","article-title":"Treatment of refractory melasma with the MedLite C6 Q-switched Nd:YAG laser and alpha arbutin: A prospective study","volume":"12","author":"Polnikorn","year":"2010","journal-title":"J. Cosmet. Laser Ther."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1111\/j.1524-4725.2010.01523.x","article-title":"Low-Fluence Q-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser for Melasma with Pre- or Post-Treatment Triple Combination Cream","volume":"36","author":"Jeong","year":"2010","journal-title":"Dermatol. Surg."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"224","DOI":"10.3109\/09546630903401462","article-title":"Low-dose 1064-nm Q-switched Nd:YAG laser for the treatment of melasma","volume":"21","author":"Choi","year":"2010","journal-title":"J. Dermatol. Treat."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e847","DOI":"10.1111\/j.1365-2230.2009.03599.x","article-title":"Melasma treatment in Korean women using a 1064-nm Q-switched Nd:YAG laser with low pulse energy","volume":"34","author":"Cho","year":"2009","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/j.1365-2230.2012.04473.x","article-title":"Histopathological study of the treatment of melasma lesions using a low-fluence Q-switched 1064-nm neodymium:yttrium-aluminium-garnet laser","volume":"38","author":"Kim","year":"2013","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1002\/lsm.20956","article-title":"A case series of facial depigmentation associated with low fluence Q-switched 1064\u2009nm Nd:YAG laser for skin rejuvenation and melasma","volume":"42","author":"Chan","year":"2010","journal-title":"Lasers Surg. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"340","DOI":"10.5021\/ad.2015.27.3.340","article-title":"Changes in Melanin and Melanocytes in Mottled Hypopigmentation after Low-Fluence 1064-nm Q-Switched Nd:YAG Laser Treatment for Melasma","volume":"27","author":"Jang","year":"2015","journal-title":"Ann. Dermatol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1111\/j.1524-4725.2012.02397.x","article-title":"Punctate leucoderma after low-fluence 1064-nm quality-switched neodymium-doped yttrium aluminum garnet laser therapy successfully managed using a 308-nm excimer laser","volume":"38","author":"Kim","year":"2012","journal-title":"Dermatol. Surg."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"290","DOI":"10.3109\/14764172.2013.769762","article-title":"A case of mottled hypopigmentation after low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser therapy","volume":"15","author":"Ryu","year":"2013","journal-title":"J. Cosmet. Laser Ther."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1111\/j.1524-4725.2010.01751.x","article-title":"Punctate leucoderma after 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser with low-fluence therapy: Is it melanocytopenic or melanopenic?","volume":"36","author":"Kim","year":"2010","journal-title":"Dermatol. Surg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"751","DOI":"10.5021\/ad.2015.27.6.751","article-title":"Hypopigmentation Induced by Frequent Low-Fluence, Large-Spot-Size QS Nd:YAG Laser Treatments","volume":"27","author":"Wong","year":"2015","journal-title":"Ann. Dermatol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1002\/lsm.22735","article-title":"Efficacy and safety of a novel picosecond laser using combination of 1064 and 595\u2009nm on patients with melasma: A prospective, randomized, multicenter, split-face, 2% hydroquinone cream-controlled clinical trial","volume":"49","author":"Choi","year":"2017","journal-title":"Lasers Surg. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1007\/s10103-020-03008-z","article-title":"Clinical improvement of photoaging-associated facial hyperpigmentation in Korean skin with a picosecond 1064-nm neodymium-doped yttrium aluminum garnet laser","volume":"35","author":"Kim","year":"2020","journal-title":"Lasers Med. Sci."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1002\/lsm.23244","article-title":"A Systematic Review of Picosecond Laser in Dermatology: Evidence and Recommendations","volume":"53","author":"Wu","year":"2021","journal-title":"Lasers Surg. Med."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/7\/936\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:50:49Z","timestamp":1760140249000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/7\/936"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,14]]},"references-count":63,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["medicina58070936"],"URL":"https:\/\/doi.org\/10.3390\/medicina58070936","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,14]]}}}