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Safe and effective treatment of melasma in dark-skinned patients

A split-faced, randomized study compares full beam and fractionated beam of a 755-nm picosecond laser on the efficacy in clearing melasma.

By Emilee Green | Sep 23, 2020

september-ec-manuskiattiWausau, WI (September 23, 2020) – Melasma is a dermatological condition that is very common in patients with darker skin types. Traditional treatment approaches with topical medications and chemical peels commonly are utilized, but due to their refractory and recurrent nature, patients often seek adjunctive treatments to improve melasma clearance. The use of lasers and energy-based devices have shown promise but with varying degrees of success, and an increased risk for post-inflammatory hyper- or hypopigmentation. This study aims to compare the efficacy and safety of a 755-nm picosecond laser for the treatment of melasma in a split-face manner, with one side treated with a fractionated beam (diffractive lens array [DLA]) and the other side with a full-beam (flat optics).

This clinical report, published in Lasers in Surgery and Medicine (LSM), the official journal of the American Society for Laser Medicine and Surgery, Inc. (ASLMS), was selected as the September 2020 Editor’s Choice.

The study, led by Woraphong Manuskiatti, MD, is titled “A Prospective, SplitFace, Randomized Study Comparing a 755nm Picosecond Laser With and Without Diffractive Lens Array in the Treatment of Melasma in Asians.”  

“Treatment of melasma with lasers remains a challenge due to its limited clinical efficacy in addition to high rates of recurrence and side effects. This study demonstrates that a 755-nm picosecond laser is safe and effective for the treatment of melasma in dark-skinned individuals,” said Manuskiatti.

Pigment clearance significantly improved from 1 to 6 months after the treatment on each side. There were no statistically significant differences in physician rating scores between the two treatment techniques at all follow-up visits. However, the study noted that the sides treated with full-beam (flat optics) had a lower incidence of post-inflammatory hyperpigmentation than the fractionated side.

Dr. Manuskiatti is a Professor of Dermatology and leads the Siriraj Skin Laser Center at the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. In addition to training numerous medical students and Dermatology residents, Dr. Manuskiatti continues to see patients and engage in clinical research. He has published over 80 original medical articles and ten international book chapters in the fields of cutaneous laser and dermatologic surgery. Since 2006, Dr. Manuskiatti has both led and lectured at numerous local and international conferences in laser and dermatologic surgery. Furthermore, he founded and currently serves as program director for the month-long Siriraj International Short Course Training in skin laser surgery.

Editor’s Choice is an exclusive article published in LSM, the official journal of the ASLMS. View the complete manuscript.

The American Society for Laser Medicine and Surgery, Inc. (ASLMS) is the largest multidisciplinary professional organization dedicated to the development and application of lasers and related technology for health care applications. ASLMS promotes excellence in patient care by advancing biomedical application of lasers and other related technologies worldwide. ASLMS membership includes physicians, surgeons, nurses and allied health professionals representing multiple specialties, physicists involved in product development, biomedical engineers, biologists, industry representatives and manufacturers. For more information, visit


The American Society for Laser Medicine and Surgery is the world’s largest scientific organization dedicated to promoting research, education and high standards of clinical care in the field of medical laser applications. It provides a forum for the exchange of scientific information and participation in communicating the latest developments in laser medicine and surgery to clinicians, research investigators, government and regulatory agencies, and the public.

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