GLASS LAB · Medical Aesthetics Evidence Index 303 cells · 19,226 papers · 5,969 top-tier evidence

Pigment · Cafe-au-lait macule

Laser toning qswitched or picosecond evidence for Cafe-au-lait macule

B 51.1 / 100 Supported 2 RCT/meta · 4 clinical/observational · 5 case · 15 total
Good evidence · positive conclusion

There is a relatively good level of clinical evidence, and a majority of papers support its effectiveness.

Grade combines the quantity and quality of the research, while direction is a separate signal showing how the papers assess effectiveness.

Includes meta-analysis/SR Median year 2016 Last 5 years 27% Positive results 67% Negative results 2 Korea/Asia 4

Known in Korea as

토닝밀크토닝수소토닝스펙트라레이저 토닝바디착색토닝레블라이트 SI셀룰라이트 토닝지우개 멀티토닝헬리오스 785

Procedure and brand names vary, but the evidence above applies to the same procedure mechanism.

Key papers

tier1 Lasers and Energy-Based Devices for Treatment of Pigmented Lesions With Histologic and Ultrastructural Imaging Correlation: A Systematic Review. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] · 2025 · PMID 40767860

Abstract summary (English) BACKGROUND: Understanding histologic and ultrastructural changes in pigmented lesions after laser/energy-based device (EBD) treatment is essential for elucidating treatment mechanisms, optimizing outcomes, and preventing complications. OBJECTIVE: To summarize histologic and imaging findings after laser/EBD for pigmented lesions. METHODS: A systematic review using PubMed identified 39 studies examining laser/EBD...

Systematic Review, Journal Article, Review

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tier1 Comparison of the efficacy and safety between a low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser and a conventional Q-switched 532-nm laser for the treatment of cafe-au-lait macules in 40 Chinese children: a prospective, randomized, parallel-controlled, evaluator-blinded trial. Lasers in medical science · 2021 · PMID 33442853

Abstract summary (English) Cafe-au-lait macules (CALMs) affect the appearance of patients and can result in serious psychological problems. Successful treatments without adverse effects remain challenging. We designed a prospective, randomized, controlled, evaluator-blinded trial on 40 pediatric patients to compare the efficacy between a low-fluence 1064-nm Q-switched Nd:YAG laser and a Q-switched Nd:YAG 532-nm laser for the treatment of...

Journal Article, Randomized Controlled Trial

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tier2 Comparison of the safety and efficacy of low fluence Q-switched 1064-nm and conventional Q-Switched 755-nm lasers in the treatment of café-au-lait macules: A prospective self-controlled trial. Lasers in surgery and medicine · 2022 · PMID 36084202

Abstract summary (English) BACKGROUND: Conventional high fluence Q-switched (HFQS) Alexandrite 755-nm are widely used in clinical café-au-lait macules (CALMs) treatment. There have been recent concerns regarding the efficacy and safety of low fluence Q-switched (LFQS) Nd: YAG 1064-nm lasers. OBJECTIVE: To evaluate the efficacy and safety of the conventional HFQS and LFQS laser in the treatment of CALMs.

Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't

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tier2 Treatment of pigmentary disorders in patients with skin of color with a novel 755 nm picosecond, Q-switched ruby, and Q-switched Nd:YAG nanosecond lasers: A retrospective photographic review. Lasers in surgery and medicine · 2016 · PMID 26922302

Abstract summary (English) BACKGROUND AND OBJECTIVES: Laser procedures in skin of color (SOC) patients are challenging due to the increased risk of dyspigmentation and scarring. A novel 755 nm alexandrite picosecond laser has demonstrated effectiveness for tattoo removal and treatment of acne scars. No studies to date have evaluated its applications in pigmentary disorders.

Comparative Study, Journal Article

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tier2 A low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminium garnet laser for the treatment of café-au-lait macules. Journal of the American Academy of Dermatology · 2015 · PMID 26169691

Abstract summary (English) BACKGROUND: Café-au-lait macules (CALMs) are a common pigmentary disorder. Although a variety of laser modalities have been used to treat CALMs, their efficacies vary and dyspigmentation may develop. OBJECTIVE: We evaluated the clinical efficacy and safety of a low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminium garnet (Nd:YAG) laser for the treatment of CALMs.

Comparative Study, Journal Article, Research Support, Non-U.S. Gov't

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tier2 Treatment of epidermal pigmented lesions with the frequency-doubled Q-switched Nd:YAG laser. A controlled, single-impact, dose-response, multicenter trial. Archives of dermatology · 1994 · PMID 7986124

Abstract summary (English) BACKGROUND AND DESIGN: The removal of benign, aesthetically important, pigmented lesions can be effectively treated with multiple modalities. Selective removal of the pigment by lasers is becoming increasingly popular. A three-center trial evaluated the effectiveness of the frequency-doubled Q-switched neodymium (Nd):YAG laser (532 nm, 2.0-mm spot size, 10 nanoseconds) in removing benign epidermal pigmented lesions...

Clinical Trial, Controlled Clinical Trial, Journal Article, Multicenter Study

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tier0_review Laser therapy of pigmented lesions: pro and contra. Acta dermatovenerologica Croatica : ADC · 2010 · PMID 20887701

Abstract summary (English) Although frequently performed, laser removal of pigmented lesions still contains certain controversial issues. Epidermal pigmented lesions include solar lentigines, ephelides, café au lait macules and seborrheic keratoses. Dermal lesions include melanocytic nevi, blue nevi, drug induced hyperpigmentation and nevus of Ota and Ito.

Journal Article, Review

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tier3 Treatment of Laser Therapy-Induced Punctate Leukoderma Using a 308-nm Excimer Laser. Annals of dermatology · 2017 · PMID 28966523

Abstract summary (English) Punctate leukoderma presents as numerous, distinct, round or oval depigmented spots. Recently, laser therapy-induced punctate leukoderma associated with various Q-switched laser and carbon dioxide laser have been reported. A 25-year-old man presented with numerous, discrete, round, confetti-like, depigmented macules on his left neck.

Case Reports, Journal Article

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tier3 Fractional 532-nm Q-switched Nd:YAG laser: One of the safest novel treatment modality to treat café-au-lait macules. Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology · 2016 · PMID 26962881

Abstract summary (English) Café-au-lait macules (CALMs) are benign epidermal basilar hyperpigmentations that can be found in an isolated form or in association with neurocutaneous syndromes. Frequency-doubled Q-switched neodymium-doped yttrium aluminum garnet laser (532-nm QSNYL) does not penetrate deeply into the skin and is therefore suitable for epidermal pigmented lesion. Fractional photothermolysis (FP) targets only very small areas of...

Case Reports, Journal Article

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tier_other The treatment of infantile giant café au lait spot using golden parameter therapy with a high fluence 1064-nm Q-switched Nd: YAG laser. The Journal of dermatological treatment · 2024 · PMID 39134061

Abstract summary (English) BACKGROUND: Infantile café au lait spot is a brown macule with various sizes (diameter: 0.5 cm-30 cm). Infantile giant café au lait spot (IGCALS) is a huge (diameter >20cm) irregular-shaped benign hyperpigmented skin disorder that arises in infants. There has been no clearly established laser treatment consensus for the treatment of IGCALS because infants are too fragile to receive laser treatment with long hours...

Journal Article

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Suggested interpretation

Strong evidence base

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