Background and Objectives: Riehl's melanosis is a chronic acquired hyperpigmentation disorder that causes significant cosmetic problems for patients with this condition. Several treatment options, including low-fluence Q-switched Nd:YAG (QSNY) 1064-nm laser treatment, have been attempted with inconsistent results. We aimed to investigate the beneficial effect of mid-fluence QSNY 1064-nm laser in the treatment of Riehl's melanosis. Study Design/Materials and Methods: A retrospective review was conducted on patients repetitively treated with mid-fluence (3.5–5 J/cm2 with a spot size of 5 mm and a pulse rate of 10 Hz) QSNY 1064-nm laser. Twenty-one patients with Riehl's melanosis were involved. Clinical photographs, treatment parameters, and side effects were reviewed to assess the safety and efficacy of the modality. Results: The mean age of the patients was 57.00 ±8.2 years, and there were 20 female patients and 1 male patient. The mean number of treatment sessions was 5.95 ± 3.6, and the mean interval between each session was 39.12 ± 13.4 days. After treatment, the mean melasma area and severity index score decreased from 12.53 ± 10.2 to 5.98 ± 5.3. At the final visit, 16 of the 21 (76.1%) patients were considered to have moderately or very much improved. No severe side effects were observed. Conclusions: Repetitive mid-fluence QSNY 1064-nm laser treatment may be an effective and safe optional modality for Riehl's melanosis. Lasers Surg. Med.
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