A study in 20 melasma patients investigated the effects of low-dose 1064 nm Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser (QSNYL) on skin changes before and after treatment. The therapy was administered 5 times at 1-week intervals using fluences of 2.0-3.5 J/cm2 to treat the whole face. Sunscreen was used during treatment but no other therapies were applied. Four weeks after the fifth treatment, the lightness of the skin (measured by chromatometer) was increased (L-value: 0.86; P = 0.002) and the melanin index decreased (−28.23; P < 0.001). Skin wrinkling (measured by Visioscan) was decreased, but skin hydration and elasticity were unaffected. The therapy was well tolerated and no hyper- or hypopigmentation ...