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Low-fluence 1064-nm Q-switched Nd:YAG laser effectively treats small café-au-lait macules

A low-fluence 1064-nm Q-switched Nd:YAG laser treatment displayed greater efficacy than a 532-nm laser in treating patients’ café-au-lait macules, according to recently published study results.

South Korean researchers conducted a preliminary study of six patients with café-au-lait macules (CALMs) who underwent a split-lesion comparison of 532-nm and 1064-nm Q-switched Nd:YAG laser treatment. In a subsequent prospective trial to measure safety and efficacy, 32 patients (18 female, mean age, 16.3 years) with 39 CALMs received low-fluence 1064-nm Q-switched Nd:YAG laser therapy.

Patients in the initial study treated with the 1064-nm laser had a more favorable response and shorter recovery time compared with the 532-nm laser treatment. A clinical response classified as good or better was achieved in all patients in the 1064-nm treatment group vs. a 67% response in the patients treated with the 532-nm laser.

Complete clearance of lesions occurred in 12 CALMS (30.8%) among patients in the prospective trial. At least 50% clearance occurred in 29 treated lesions (74.4%). Adverse events were reported by 15.4% of the patients.

More than 85.7% of lesions measuring less than 16 cm² displayed a complete response; no lesions larger than 16 cm² showed a complete response.

“Our analysis revealed that lesion size was the best predictor of a complete response,” the researchers concluded. “We hypothesize that large CALMs exhibited poorer outcomes because it is difficult to deliver energy evenly over a large area when the laser frequency is high (10 Hz). Therefore, we suggest that low-fluence 1064-nm Nd:YAG laser treatment is an effective treatment option for patients with lesions that are relatively small ( < 16 cm²).” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.