Successful Treatment of Riehl's Melanosis With Mid-Fluence Q-Switched Nd:YAG 1064-nm Laser

Background and Objectives Riehl's melanosis is a chronic acquired hyperpigmentation disorder that causes significant cosmetic problems for patients with this condition. Several treatment options, including low-fluence Q-switched Nd:YAG (QSNY) 1064-nm laser treatment, have been attempted with inconsistent results. We aimed to investigate the beneficial effect of mid-fluence QSNY 1064-nm laser in the treatment of Riehl's melanosis. Study Design/Materials and Methods A retrospective review was conducted on patients repetitively treated with mid-fluence (3.5-5 J/cm(2) with a spot size of 5 mm and a pulse rate of 10 Hz) QSNY 1064-nm laser. Twenty-one patients with Riehl's melanosis were involved. Clinical photographs, treatment parameters, and side effects were reviewed to assess the safety and efficacy of the modality. Results The mean age of the patients was 57.00 +/- 8.2 years, and there were 20 female patients and 1 male patient. The mean number of treatment sessions was 5.95 +/- 3.6, and the mean interval between each session was 39.12 +/- 13.4 days. After treatment, the mean melasma area and severity index score decreased from 12.53 +/- 10.2 to 5.98 +/- 5.3. At the final visit, 16 of the 21 (76.1%) patients were considered to have moderately or very much improved. No severe side effects were observed. Conclusions Repetitive mid-fluence QSNY 1064-nm laser treatment may be an effective and safe optional modality for Riehl's melanosis. Lasers Surg. Med. (c) 2020 Wiley Periodicals, Inc.