Research Article

Safety and Efficacy of Combined Low Fluence Q-switched Nd:YAG 1064nm Laser with Pulsed Dye Laser 595nm in Melasma Control Among Malaysians: Does Adding Polynucleotides High Purification Technology (PN HPT™) Lead to a Difference?

Authors: Lim Lee Naa, Chew Phoay Koon, Yuen Shan Ling, Ng Poh Ling, Nicole Ng I, Ng Chia Wen, Adibah Hanim binti Ismail.

DOI: 10.33425/2689-1093.1100

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Abstract

Background: Melasma is a form of acquired skin hyperpigmentation that is more prevalent among middle-aged women with Fitzpatrick skin types III, IV, and V. While highly preventable, the condition has a relatively high recurrence rate, especially with monotherapy. As a result, evaluating the effectiveness of combination therapies may be beneficial in treating melasma.

Methods: This study retrospectively examined the medical records of 50 patients with melasma, divided into two groups. The first retrospective group of 25 patients had previously been treated with a low-fluence Q-switched Nd:YAG 1064nm laser and a pulsed dye laser 595nm, along with add-on intradermal Polynucleotides High Purification Technology (PN HPT™). The second group, also consisting of 25 patients, received treatment with a low fluence of a Q-switched Nd:YAG laser at 1064nm and a pulsed dye laser 595nm. The modified Melasma Area and Severity Index (mMASI) was compared retrospectively in the two groups over the observation period from November 2023 to June 2025.

Results: Both patient groups showed significant improvement by the end of the study compared to baseline, with a statistically significant difference between the two groups. The combination of laser and add-on PN HPT™ showed a more substantial reduction in mean mMASI scores than laser alone, both after 8 weeks (–12.8% vs. –9.3%, respectively) and 16 weeks (–24.4% vs. –16.0%, respectively, p< 0.05 between the two treatment groups).

Conclusion: Treatment with laser alone showed a slower improvement rate in the early weeks of the cycle compared to the combination of laser and add-on PN HPT™. Besides accelerating initial melasma improvement, the combination of subdermal PN HPT™ via cannula and laser led to a statistically significant and more noticeable improvement in hyperpigmentation disorders by the end of the cycle. However, more studies are needed to confirm the role of polynucleotides in melasma treatment.

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