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December 1994

Treatment of Epidermal Pigmented Lesions With the Frequency-Doubled Q-Switched Nd:YAG Laser: A Controlled, Single-Impact, Dose-Response, Multicenter Trial

Author Affiliations

From the Department of Dermatology, Wellman Laboratories of Photomedicine, Harvard Medical School, Boston, Mass (Drs Kilmer and Anderson); Department of Dermatology, University of California—Davis, Sacramento, (Dr Wheeland); and Skin Laser Center, Pascack Valley Hospital, Westwood, NJ, and Division of Dermatology, New Jersey Medical School, Newark (Dr Goldberg).

Arch Dermatol. 1994;130(12):1515-1519. doi:10.1001/archderm.1994.01690120051007

Background and Design:  The removal of benign, aesthetically important, pigmented lesions can be effectively treated with multiple modalities. Selective removal of the pigment by lasers is becoming increasingly popular. A threecenter trial evaluated the effectiveness of the frequencydoubled Q-switched neodymium (Nd): YAG laser (532 nm, 2.0-mm spot size, 10 nanoseconds) in removing benign epidermal pigmented lesions with a single treatment. Fortynine patients were treated for multiple lentigines (n=37), for cafe au lait macules (n=7), and for miscellaneous lesions (n=5). Treatment areas were divided into four quadrants, irradiated with fluences of 2,3,4, or 5 J/cm2 and evaluated at 1- and 3-month intervals following treatment.

Results:  For lentigines, response was related to dose with a greater than 75% pigment removal achieved in 60% of those lesions treated at higher energy fluences. Responses were more variable with other lesions, with fair-to-good improvement noted in most cases. Mild, transient erythema; hypopigmentation; and hyperpigmentation were noted in several patients, but resolved spontaneously within 3 months. No other textural changes, scarring, or other side effects were noted.

Conclusion:  The frequency-doubled Q-switched Nd: YAG laser (532 nm) safely and effectively treats benign epidermal pigmented lesions.(Arch Dermatol. 1994;130:1515-1519)