Q-Switched 1064 nm Nd:YAG Laser in Treating Axillary Hyperpigmentation in Filipino Women With Skin Types IV-V

January 2020 | Volume 19 | Issue 1 | Original Article | 66 | Copyright © January 2020


Published online December 5, 2019

Irene Gaile C. Robredo

St Luke’s Medical Center Global City, Taguig City, Philippines; Asian Hospital and Medical Center, Muntinlupa City, Philippines; beautiqueMD, Taguig City, Philippines; dermHQ, Makati City, Philippines

Since axillary hyperpigmentation is considered a common disorder associated mainly with darker skin types and poses a major influence on quality of life, we focused on Filipino women with skin types IV-V with axillary hyperpigmentation. Objective analysis of pigmentation showed a marked reduction in after 4 laser treatments. Paired clinical improvement scoring both by the treating physician and patients proved that following 4 treatments, all lesions reported pigment reduction compared to baseline. Previous studies have shown that pigments treated with QS Nd:YAG exhibited recurrence of pigment after a few months or even cases in which the laser treatment itself produced PIH.7 We found that the low-fluence treatment protocol spaced 2 weeks apart did not induce additional PIH in any of the patients and that reduction in pigmentation was sustained for at least 3 months after the final treatment session. Furthermore, none of the major adverse events of traditional laser treatments such as pain, burning, or edema were noted. Pain scored throughout the trial was tolerable as shown by the consistent reduction in VAS scores after each treatment session.

CONCLUSION

Axillary hyperpigmentation is a common and problematic aesthetic condition that has not been extensively studied, although presenting high prevalence among females of dark skin types. Our study supports previous preliminary data that showed a minimum 3 laser treatments for PIH in the axillary area. We found that low fluence QS 1064nm Nd:YAG nanosecond laser treatment is a safe and effective treatment option for PIH associated axillary pigmentation. Our data show marked improvement in pigmentation, which was sustained for as long as three months after the final treatment with no related adverse events or treatment related PIH.

Further investigation and large-scale clinical studies are necessary to substantiate clinical significance of low0fluence QS 1064nm Nd:YAG laser in the treatment of PIH.

DISCLOSURES

The author has no conflicts of interest to declare.

REFERENCES

1. Lamel SA, Rahvar M, Maibach HI. Postinflammatory hyperpigmentation secondary to external insult: an overview of the quantitative analysis of pigmentation. Cutan Ocul Toxicol. 2013;32(1):67-71.

2. Davis EC, Callender VD. Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol. 2010;3(7):20-31.

3. Nouveau S, Agrawal D, Kohli M, Bernerd F, Misra N, Nayak CS. Skin hyperpigmentation in indian population: insights and best practice. Indian J Dermatol. 2016;61(5):487-95.

4. Ghannam S, Al Otabi FK, Frank K, Cotofana S. Efficacy of low-fluence Nd:YAG 1064 nm laser for the treatment of post-inflammatory hyperpigmentation in the axillary area. J Drugs Dermatol. 2017;16(11):1118-1123.

5. Lacz NL, Vafaie J, Kihiczak NI, Schwartz RA. Postinflammatory hyperpigmentation: a common but troubling condition. Int J Dermatol. 2004;43(5):362-5.

6. Silpa-Archa N, Kohli I, Chaowattanapanit S, Lim HW, Hamzavi I. Postinflammatory hyperpigmentation: A comprehensive overview: epidemiology, pathogenesis, clinical presentation, and noninvasive assessment technique.J Am Acad Dermatol. 2017;77(4):591-605.

7. Chaowattanapanit S, Silpa-Archa N, Kohli I, Lim HW, Hamzavi I. Postinflammatory hyperpigmentation: a comprehensive overview: treatment options and prevention. J Am Acad Dermatol. 2017;77(4):607-621.

8. Battle EF, Hobbs LM., Laser surgery on darker ethnic skin. Dermatol Clin. 2003;21(4):713-23.

9. Agbai O, Hamzavi I, Jagdeo J. Laser treatments for postinflammatory hyperpigmentation: a systematic review. JAMA Dermatol. 2017;153(2):199-206.

10. Lee YJ, Shin HJ, Noh TK, Choi KH, Chang SE. Treatment of melasma and post-inflammatory hyperpigmentation by a picosecond 755-nm alexandrite laser in Asian Patients. Ann Dermatol. 2017;29(6):779-781.

11. Castanedo-Cazares JP, Lárraga-Piñones G, Ehnis-Pérez A, Fuentes-Ahumada C, Oros-Ovalle C, Smoller BR, Torres-Álvarez B. Topical niacinamide 4% and desonide 0.05% for treatment of axillary hyperpigmentation: a randomized, double-blind, placebo-controlled study. Clin Cosmet Investig Dermatol. 2013;6:29-36.

12. Pooja A, Sarkar R, Garg VK, Arya L. Lasers for treatment of melasma and post-inflammatory hyperpigmentation. J Cutan Aesthet Surg. 2012;5(2):93- 103.

13. Cho SB, Park SJ, Kim JS, Kim MJ, Bu TS. Treatment of post-inflammatory hyperpigmentation using 1064-nm Q-switched Nd:YAG laser with low fluence: report of three cases. J Eur Acad Dermatol Venereol. 2009;23(10):1206-7.

AUTHOR CORRESPONDENCE

Irene Gaile C. Robredo MD FPDS irenegaile@gmail.com