Effect of a topical antioxidant serum containing vitamin C, vitamin E, and ferulic acid after Q-switched 1064-nm Nd:YAG laser for treatment of environment-induced skin pigmentation

Background: Extrinsic skin aging caused by atmospheric pollutants is associated with a sustained inflammatory response which is a significant risk factor for lentigines and melasma. Aims: The aim of this study was to evaluate the efficacy of topical application of combination formulation of vitamin C, vitamin E, and ferulic acid as an adjuvant to Q-switched Nd:YAG (QSNY) lasers treatment in individuals with lentigines and melasma. Methods: A single blinded, prospective, randomized split-face trial was conducted. Eighteen men and women between 26 and 53 years old were treated with a combination antioxidant serum on one randomized side of their face immediately after QSNY laser and twice daily for 2 weeks. Patients were evaluated using digital photography and spectrometry to assess the melanin index and erythema index. Melasma severity score and global improvement scores also were assessed. Results: The treated side of the face exhibited a significantly greater reduction in the melanin index. There was no significant difference in post-treatment erythema. More clinical improvement was observed on the treated side compared with the untreated side. Conclusions: Our study suggests that topical application of a combination vitamins C, E, and ferulic acid antioxidant formula may be effective as an adjuvant option in QSNY lasers.