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BACKGROUND Laser-induced postinflammatory hyperpigmentation could be a limiting factor for selecting patients appropriate for the use of ruby laser in the treatment of lentigenes, especially in dark-skinned individuals.

OBJECTIVE To evaluate the efficacy and adverse effects of Q-switched ruby laser light (694 nm) on solar lentigines in patients with Fitzpatrick skin type II, III, and IV.

METHODS AND MATERIALS Controlled comparison study in a university-based laser clinic center. Ninety-one solar lentigines in patients with skin type II, III, and IV were enrolled. All patients were followed for 6 months for frequency of side effects. Before-and-after photographs and images from all follow-up sessions were taken and then assessed by a blinded dermatologist for the evaluation of side effects.

RESULTS Complete clearance was achieved in all patients. Postinflammatory dyspigmentation occurred in 7.8% patients with Fitzpatrick skin type II, 9.8% patients with type III, and 16.6 patients with type IV (p=.67); all improved over a 6-month follow-up period.

CONCLUSION Q-switched ruby laser treatment is a safe procedure for the treatment of solar lentigines even in dark-skinned individuals. Considering routine factors in addition to melanin content alone is required for minimizing side effects, especially postinflammatory hyperpigmentation in darker skin.