Efficacy and Safety of 675-nm Laser Monotherapy for Melasma in Fitzpatrick Skin Types III–V: A Prospective Pre–Post Intervention Study

Abstract

Introduction: Melasma is a chronic pigmentary disorder that often recurs after treatment, particularly in people with darker skin who are more prone to pigmentary side effects. Methods: This prospective study evaluated the efficacy and safety of a 675-nm laser for melasma in individuals with darker skin types. Twenty-eight Thai women with Fitzpatrick skin types (FSTs) III–V underwent three monthly laser sessions using dual Moveo and Standard modes without anesthesia. Clinical severity, pigmentation, patient satisfaction, and safety were assessed up to 6 months after treatment. Results: The modified Melasma Area and Severity Index (mMASI) showed a 41% improvement at 3 months and 34% at 6 months post-treatment. Antera 3D imaging confirmed progressive melanin reduction, and over 70% of participants reported at least 50% improvement. Adverse effects were mild and transient, including mild erythema or small scabs, with no postinflammatory hyperpigmentation (PIH) observed. Conclusion: The 675-nm laser achieved sustained lightening of melasma and skin tone improvement with minimal discomfort and no downtime. These findings support the 675-nm laser as a safe and effective treatment for melasma in darker skin types, offering a potential new approach for managing this persistent condition.