Skin aging, presenting with rhytides/sagging and photodamage, and scarring from severe acne, surgery, or trauma are cosmetic disfigurements which may cause psychologic damage and prompt patients to seek advice about treatment. Solar damage of the skin leads to epidermal abnormalities, such as lentigenes and actinic keratoses, and the degeneration of collagen, which results in the formation of rhytides and telangiectasias. A variety of different treatments have been used for the rejuvenation of sun-damaged skin, including topical retinoids, bleaching agents, chemical peeling, dermabrasion, lasers and light devices. The optimum resurfacing laser provides precise skin vaporization with minimal postoperative morbidity, which depends significantly on the depth of ablation and energy fluence.

The Q-switched 1064-nm neodymium-doped yttrium aluminum garnet (QS 1064-nm Nd:YAG) laser is increasingly used for nonablative skin rejuvenation or "laser toning" for melasma. Multiple and frequent low-fluence, large-spot-size treatments are used to achieve laser toning, and these treatments are associated with the development of macular hypopigmentation as a complication. We present a case series of three patients who developed guttate hypomelanotic macules on the face after receiving laser toning treatment with QS 1064-nm Nd:YAG.
Aluminum ; Humans ; Hypopigmentation* ; Melanosis ; Rejuvenation ; Skin ; Yttrium