الفهرس 
Combined Q-switched ; YAG laser and platelet rich plasma versus Q-switched Nd:YAG laser alone in the
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Abstract
Background: Melasma is a common, acquired hyperpigmentation. QS:nd YAG laser toning refers to using multiple laser passes with large spot size and low fluence. It has shown promising results, selectively targeting the melanosomes. Platelet Rich Plasma (PRP) can decrease pigmentation and improve skin quality. Aim: To evaluate the efficacy and safety of adding PRP to Q-switched nd:YAG laser toning in the treatment of melasma and its role in sustainability of results. Methodology: This study was conducted as patient-blinded evaluator-blinded randomized-controlled split face study. The study enrolled 30 melasma patients.One side of the face was randomized to receive Q-switched Nd:YAG laser toning and PRP injections (QSL+PRP), while the other side received Q-switched Nd:YAG laser toning and saline injections (QSL+ placebo). Sessions were performed monthly for 5 months followed by 2 months follow up assessment. Hemi MASI, skin aging (rhytides, laxity and texture), Global Aesthetic Improvement Scale (GAIS), Patient Satisfaction Scale (PSS), melanin and erythema indices were used to assess improvement on each side separately. MelasQol has been used to assess the improvement in quality of life for each patient. Results: All scores significantly improved on both sides of face after treatment and at the follow up. The QSL+PRP side yielded a statistically significant better percent of improvement compared to the QSL+ placebo side after treatment and at the follow up as regards the Hemi MASI scores (P=0.005* and 0.001* respectively) and texture scores (P=0.004*and 0.001* respectively). Side effects were minimal and equal on both sides. A positive correlation was detected between the change in hemi-MASI and melanin and erythema indices