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Efficacy and safety of Q-switched laser combined with intense pulsed light in treating melasma: a meta-analysis

Zhang Y, Zheng J, Wang H, Liu X, Liu L, Zhang G

Frontiers in medicine, 2026

2,801 participants

Abstract

BACKGROUND: Melasma is a common dermatological disorder characterized by hyperpigmented facial patches, which significantly impacting patients' quality of life and imposing substantial economic burdens. Given the multifaceted impact of melasma, there is a pressing need for effective therapeutic strategies. This meta-analysis evaluates the efficacy and safety of combining Q-switched (QS) laser with intense pulsed light (IPL) vs. monotherapy for melasma.

METHODS: A systematic literature search of relevant databases was conducted to identify controlled trials comparing the combination therapy with monotherapy. Primary outcomes included changes in the Melasma Area and Severity Index (MASI) score and adverse reactions. Secondary outcomes comprised clinical efficacy rate, recurrence rate, and patient satisfaction rate. Data were pooled using a fixed-effects model.

RESULTS: A total of 31 studies involving 2,801 patients were included. Results showed that the combination therapy demonstrated a significantly greater reduction in MASI scores than monotherapy (standardized mean difference: 1.20, 95% CI: -1.36 to -1.05; p < 0.001). The pooled efficacy rate was also higher for the combination group (92.0% vs. 77.4%; risk ratio: 1.10, 95% CI: 1.03-1.17; p < 0.05). Moreover, the combination group exhibited a lower recurrence rate (8.5 vs. 17.8%; risk ratio: 0.54, 95% CI: 0.32-0.90; p < 0.05). However, no significant difference in patient satisfaction was observed between the two groups.…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,801 participants or records.

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