Efficacy and Safety of Picosecond Laser Combined With Sodium Hyaluronate for Melasma

Background: Melasma is a common hyperpigmentation disorder that presents a significant therapeutic challenge. This study aims to evaluate the efficacy and safety of a novel combination approach using a picosecond laser followed by microinjections of a sodium hyaluronate composite solution for the treatment of mixed-type melasma. Methods: In this retrospective study, 30 female patients with mixed-type melasma received 3 treatment sessions. Each session consisted of a fractional picosecond laser treatment followed by the administration of a non–cross-linked sodium hyaluronate composite solution. Efficacy was primarily assessed by the change in the Melasma Area and Severity Index score from baseline to 4 weeks posttreatment, as evaluated by an independent blinded investigator. Secondary endpoints included Physician’s Global Assessment and patient satisfaction. Results: The combination therapy resulted in a statistically significant reduction in the mean Melasma Area and Severity Index score, from a baseline of 18.30 ± 7.85 to 8.20 ± 3.50 posttreatment ( P < 0.05). Physician assessments showed marked or moderate improvement in 70% of patients, and the overall patient satisfaction rate was high (86.7%). The treatment was well tolerated with only mild, transient side effects and no serious adverse events reported. Conclusions: The combination of a picosecond laser with a sodium hyaluronate composite solution demonstrated significant short-term efficacy at 4 weeks posttreatment with an acceptable safety profile, offering a promising approach for its clinical management.