High Resolution Ultrasound for the Assessment of Melasma: Experience With 1064 nm Q - Switched Nd:YAG Laser

Sep 30, 2026

Uploaded by Jasmine

Melasma is a challenging chronic pigmentary disorder requiring reliable monitoring to optimize treatment decisions for patients and dermatologists. This prospective case series evaluated high-resolution dermatologic ultrasound (HRDU) to assess skin changes in melasma patients after collimated and fractionated 1064 nm Q-switched Nd:YAG laser therapy. Three patients underwent ultrasound examinations at baseline, 24–48 hours post-session, and three weeks after the third session.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

Introduction

Melasma overview and clinical features

Pathophysiology and treatment approaches

Q-switched Nd:YAG laser mechanism

High-resolution dermatologic ultrasound (HRDU)

Review began 11/03/2025 Review ended 12/01/2025 Published 12/08/2025 © Copyright 2025 Trujillo Ramírez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98719 Open Access Case Report High Resolution Ultrasound for the Assessment of Melasma: Experience With 1064 nm Q Switched Nd:YAG Laser Laura Trujillo Ramírez 1, María Fernanda Meza Corso 2, Claudia Gonzalez 3, Julio Roberto Amador 4, Angie Holguín 5, César González 1 1. Dermatology, Private Practice, Bogotá, COL 2. Dermatology, Universidad Libre, Cali, COL 3. Radiology/Dermatology Ultrasound, Rosario University, Bogotá, COL 4. Dermatology, Clinica el Country, Bogotá, COL 5. Dermatology, Universidad el Bosque, Bogotá, COL Corresponding author: María Fernanda Meza Corso, [mariafernandamezacorso@gmail.com](mariafernandamezacorso@gmail.com) Abstract Melasma is a challenging chronic pigmentary disorder that holds considerable significance for both patients and dermatologists. Monitoring therapeutic outcomes is essential for optimizing treatment strategies. This study aimed to apply high-resolution dermatologic ultrasound (HRDU) to evaluate skin changes in melasma patients and document the effects observed following the application of collimated and fractional forms of 1064 nm Q-switched Nd:YAG (QSNY) laser therapy. In a prospective case series conducted from December 2024 to February 2025 at a private dermatology clinic, three patients with melasma who were indicated for QSNY laser treatment were enrolled. Each patient underwent three high-resolution dermatologic ultrasound examinations: the first before initiating QSNY laser therapy, the second 24-48 hours after the initial session, and the third three weeks following the third session. Demographic data of the sample, Melasma Severity Index (MSI) score, ultrasound grayscale, and color Doppler features were recorded and analyzed. At baseline, all patients demonstrated a subepidermal low-echogenic band (SLEB), follicular dilation, and increased vascularization in the forehead and/or cheek regions. Following the laser sessions, we observed a decrease in the SLEB, an improvement in echogenicity, and an increase in dermal capillarity. These findings provide innovative documentation of skin changes in melasma, including subclinical inflammation and solar elastosis, and highlight the potential of low fluence, fractionated QSNY laser to reduce them. HRDU emerges as a valuable tool to confirm and monitor these therapeutic benefits, supporting its role in personalized treatment strategies for melasma. Categories: Therapeutics, Radiology, Dermatology Keywords: doppler, high resolution ultrasound, melasma, melasma treatment, nd:yag laser, ultrasound doppler Introduction Melasma is an acquired, chronic, and benign disorder, consisting of irregular pigmentation of the skin [1] . In Latin America, it is a frequent reason for dermatologic consultation, affecting up to 10% of the population [2] . Clinically, it presents as brown or gray hyperpigmented macules of varying intensity, typically occurring on photoexposed areas, with a strong predilection for the face, particularly the forehead, cheeks, upper lip, and nasal dorsum [1] . As a result, melasma can substantially impact individuals’ self-esteem and overall quality of life [3] . The pathophysiology of melasma is complex, and one of the predominant mechanisms related to its appearance and relapses is chronic sun exposure [4] . Other related factors include estrogen exposure, thyroid hormone alterations, and a family history of melasma [5] . Histologically, melasma exhibits skin alterations similar to those seen in photoaging, including solar elastosis, basement membrane disruption, and increased vascularization [6] . Treatment

FAQs

What was the purpose of using high-resolution dermatologic ultrasound in this study?

To evaluate skin changes in melasma patients and document effects after 1064 nm Q-switched Nd:YAG laser therapy, using HRDU outcomes.

How was the timing of ultrasound examinations structured for the enrolled patients?

Each patient had an ultrasound before starting treatment, another 24–48 hours after the initial session, and a third three weeks after the third session.

What ultrasound findings were observed after the laser sessions?

A decrease in the subepidermal low-echogenic band (SLEB), improved echogenicity, and increased dermal capillarity were observed.

Sep 30, 2026

Uploaded by Jasmine