Objectives: To evaluate the efficacy and safety of combination treatment using Q-switched Nd:YAG 1064nm laser and pulsed dye 595nm laser with high-intensity focused ultrasound (HIFU) compared to laser-only treatment in melasma among Malaysian women.

Materials and Methods: A retrospective study analysed records of 48 patients with melasma treated at UR Klinik Malaysia between January 2023 and February 2024. Group 1 received 10 sessions of Q-switched Nd:YAG and pulsed dye laser plus three HIFU sessions. Group 2 received laser only. Treatment outcomes were measured using modified Melasma Area and Severity Index (mMASI) at the 1st, 5th, and 10th treatment sessions. Adverse reactions were documented. Repeated measures ANOVA compared treatment outcomes.

Results: Both groups showed significant mMASI score reductions. The combination group exhibited a faster reduction between the 1st and 5th sessions, with a mean difference of 1.615 (p<0.001) compared to the laser-only group, which showed a mean difference of 0.85 (p=0.05). Most patients did not experience any adverse reaction (n=18, 75%) in both groups. However, there was erythema in Group 1 (12.5%), whereas post-inflammatory hyperpigmentation was observed in Group 2 (20%).

Conclusions: Q-switched Nd:YAG 1064nm laser and pulsed dye 595nm laser combined with high-intensity focused ultrasound (HIFU) are safe and effective in treating melasma among the Malaysian population.

Dr. Lim Wen Xuan is a Malaysian medical doctor who graduated with a medical degree from Universiti Kebangsaan Malaysia (UKM). He is currently practicing at UR Klinik, where he focuses on medical aesthetic treatments. He holds a recognized Medical Aesthetic Certification and is a licensed medical practitioner under the Malaysian Letter of Credentialing and Privileging (LCP),  ensuring safe, ethical, and evidence-based aesthetic care.