The Split-Face Comparison of the Combined Er-YAG Laser and Hydroquinone 4% With Hydroquinone 4% Alone in the Treatment of Melasma in Iranian Patients: A Prospective, Interventional Case Study

Introduction: melasma is one of the most common skin pigmentation disorders, which mostly affects the facial skin and has a considerable psychological impact on the patients. melasma management has been one of the controversial issues in dermatology. we aimed to compare the combined treatment of the er: yag (erbium: yttrium–aluminum–garnet) laser plus hydroquinone (hq) 4% with hq 4% alone in the treatment of melasma. methods: twenty-nine patients were treated with the combined er: yag laser and hq 4% on one side of the face with hq 4% alone on the other side. three sessions of the laser rat 4-week intervals. the outcome was calculated using the melasma area severity index (masi). results: the side that received the combined treatment (laser + hq 4%) showed a statistically significant reduction in masi compared to the side treated with hq 4% alone. conclusion: our study suggests the superiority of the combination of the er: yag laser and hq 4% in the treatment of melasma compared to hq 4% alone.