Fractional and Non‐Fractional Picosecond Nd:YAG Lasers Combined With Fractional Picosecond KTP Laser for the Treatment of Melasma in Female Chinese

Background and Objectives Melasma is a chronic pigmented lesion on the face that is challenging to treat. Single laser treatments are usually ineffective. Recently, picosecond lasers are becoming an emerging option for the treatment of melasma. This study aimed to evaluate the efficacy and safety of fractional and non‐fractional picosecond Nd:YAG lasers (PSNL) combined with fractional picosecond KTP laser (PSKL) on melasma in female Chinese. Methods Forty‐eight Chinese patients with facial melasma were selected and divided into two groups. Every 4 weeks, each patient received one treatment, for a total of six treatments. Treatment was administered to 24 patients using fractional and non‐fractional PSNL in the Nd:YAG group and fractional PSKL combined with fractional and non‐fractional PSNL in the Nd:YAG+KTP group. Pain scores and adverse reactions were noted following each treatment, and the modified Melasma Area Severity Index (mMASI) and patient satisfaction were assessed 1 month following every two treatments. Results The mMASI scores of both groups showed a considerable decline from the baseline. Following six treatments, the Nd:YAG+KTP group's mean mMASI score was 2.29 ± 0.82, while the Nd:YAG group was 2.87 ± 0.68. This difference was statistically significant ( p < 0.05). At every stage of the procedure, the Nd:YAG+KTP group experienced higher patient satisfaction than the Nd:YAG group. In comparison to the Nd:YAG group, which had a pain score of 2.75 (2.54, 3.00), the Nd:YAG+KTP group had a higher pain score of 3.00 (3.00, 3.17). During the study, no severe side effects were seen in the treated areas, including blisters, hypopigmentation, or post‐inflammatory hyperpigmentation (PIH). Conclusion The efficacy of fractional and non‐fractional PSNL combined with fractional PSKL in the treatment of melasma is significantly better than that of using single wavelength fractional and non‐fractional PSNL, with higher patient satisfaction and less adverse reactions.