The study compares

  • trichloroacetic acid (TCA): treatment applied every 2 weeks up to 8sessions


  • double frequency Q-switched Nd;YAG laser (1064nm and 532nm): treatment done once a month up to 6 sessions



Methods (and comments)

65 adult female patients were included

Wood’s light to determine depth (sometimes unreliable)

Evaluation through MASI: not reliable (Link)

Follow up three months after the last treatment for recurrence



Group 1

  • -epidermal location of the pigmentation
  • -n (number of patients) = 15,  TCA 20%



Group 2

  • -dermal and mixed (epidermal and dermal)
  • -n=20, TCA 25%



Group 3

  • -dermal and mixed
  • -n=15, TCA 30%



Group 4


-7 with epidermal with wavelength at 532nm

-8 dermal mixed location with wavelength at 1064nm



Results show that the biggest improvement (64.7% +/- 21.9%) was seem in group 2 (TCA25%).

  • -The condition actually worsened in group 4 (laser): (-49.2% +/- 66.3&)
  • -Recurrence rate was 32% similar in all 4 groups



Conclusion and comment. Lasers actually worsened the melasma and this could be through the induction of post-inflammatory hyperpigmentation.



No conflicts of interest disclosed

Source of information: Alaa E. et al. P1422. Q-switched Nd:YAG laser versus trichloroacetic acid peeling in the treatment of melasma among Egyptian patients. European Academy of Dermatology and Venereology (EADV) Annual Meeting – Istanbul, Turkey, 2-6 October 2013

Picture credit: wikipedia