Introduction: Dermal Pigmentation of face and neck is a common refractory condition of varied etiology with minimal effective remedial modalities available. Inspired by the study of combined IPL plus 1064nm QS- ND: Yag treatment for melasma by Cunha et al from Brazil, where they showed moderately good results in decreasing melasma pigmentation, we conducted a study on three patients of refractory melanosis of face and neck with the a similar combination of laser lights.
Material and Methods: Out of the three patients, two were of lichen planus pigmentosus (LPP) of primarily neck and face of recent onset while third one was of toxic melanosis of face and neck of long duration. There were two females and one male with age ranging from 32- 58 yrs. They were given a first session of IPL with 1) 560nm filter with a pulse of 50 ms and fluence of 22 J/cm, 2) 590nm filter with 50 ms pulse and fluence of 12 J/sq cm and 3) 530nm filter with 50ms pulse and fluence of 24-30 J/sq cm (different areas of face and neck) followed by four sessions of 1064 nm QS- ND:Yag in a dose of 500mJ (LPP cases) and 300mJ Toxic melanosis at an interval of two weeks each. Photographs were taken at baseline, at the end of treatment and two months after end of treatment.
Results: Two of the patients with LPP pigmentation showed moderately good results by decrease of pigmentation of almost 70- 80%, while the third one did not show much difference.
Conclusion: Combined treatment with IPL plus QS-ND: Yag laser provides an option for the otherwise refractory melanosis of LPP while the toxic melanosis remains a poor responder. Larger studies are required to further assess this modified laser modality of IPL combined with QS-ND: Yag.