The Safety and Efficacy of Treatment With a 1,927-nm Diode Laser With and Without Topical Hydroquinone for Facial Hyperpigmentation and Melasma in Darker Skin Types

Dermatol Surg. 2018 Oct;44(10):1304-1310. doi: 10.1097/DSS.0000000000001521.


Background: The nonablative, fractional, 1,927-nm diode laser is theoretically a safe and effective treatment for hyperpigmentation and melasma in darker skin and may potentiate topical cosmeceutical delivery.

Objective: To evaluate the use of a nonablative, fractional, 1,927-nm diode laser with and without topical 2% hydroquinone (HQ) cream for moderate-to-severe facial hyperpigmentation in Fitzpatrick skin Types III-V.

Methods: Forty adults underwent 4 laser treatments at 2-week intervals and were randomized to daily application of 2% HQ cream or moisturizer. Follow-ups were conducted 4 and 12 weeks after the final laser treatment.

Results: Hydroquinone and moisturizer groups demonstrated Mottled Pigmentation Area and Severity Index improvements of approximately 50% at post-treatment Weeks 4 and 12. Blinded investigator-assessed hyperpigmentation and photodamage improved significantly for both the groups at post-treatment Weeks 4 and 12. Subject satisfaction improved significantly in both the groups by post-treatment Week 4. Although investigator-rated Global Aesthetic Improvement Scale scores were significantly better in the HQ group at post-treatment Week 12, satisfaction was higher among those using moisturizer. No adverse events were noted.

Conclusion: The nonablative, fractional, 1,927-nm diode laser produced significant improvement in hyperpigmentation in Fitzpatrick skin Types III-V by 4 weeks, with maintenance of results at 12 weeks after treatment even without HQ.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Cutaneous
  • Adult
  • Aged
  • Antioxidants / administration & dosage*
  • Face
  • Female
  • Humans
  • Hydroquinones / administration & dosage*
  • Hyperpigmentation / therapy*
  • Laser Therapy*
  • Lasers, Semiconductor / therapeutic use*
  • Male
  • Melanosis / therapy*
  • Middle Aged
  • Patient Satisfaction
  • Single-Blind Method
  • Skin Cream
  • Skin Pigmentation
  • Treatment Outcome


  • Antioxidants
  • Hydroquinones
  • hydroquinone