Abstract: 【Abstract】 Objective To evaluate the efficacy of long-pulsed 1 064-nm Nd:YAG laser combined with a topical cream containing Camellia reticulata and Radix Notoginseng in the treatment of melasma. Methods A total of 80 patients with melasma were collected from Department of Dermatology, People′s Hospital of Ningxia Hui Autonomous Region from June 2019 to June 2020, and randomly and equally divided into control group and observation group by using a random number table: 40 patients in the control group were treated with long-pulsed 1 064-nm Nd:YAG laser once every 2 weeks for 6 sessions as a course of treatment; another 40 in the observation group were treated with the same laser therapy as the control group and a topical cream containing Camellia reticulata and Radix Notoginseng twice a day for 3 months as a course of treatment. Melasma area and severity index （MASI）, clinical efficacy, patient satisfaction rate and safety were compared between the 2 groups before and/or after treatment. Results After 4- and 8-week treatment, there was no significant difference in the MASI score between the observation group （14.57 ± 3.22 points, 10.00 ± 2.94 points, respectively） and control group （14.74 ± 3.11 points, 11.31 ± 3.00 points, respectively; both P＞0.05）. After 12-week treatment, the MASI score was significantly lower in the observation group （4.80 ± 2.78 points） than in the control group （7.07 ± 3.22 points, t = -3.38, P＜0.01）. After 3-month treatment, the response rate was significantly higher in the observation group （36 cases, 90%） than in the control group （31 cases, 77.5%; χ2 = 4.58, P < 0.001）; however, there was no significant difference in the patient satisfaction rate between the observation group （35 cases, 87.5%） and control group （29 cases, 72.5%; χ2 = 7.26, P = 0.06）. In addition, no significant difference in the occurrence of adverse reactions was observed between the observation group （5 cases, 12.5%） and control group （7 cases, 17.5%; P > 0.05）. Conclusion Compared with the long-pulsed 1 064-nm Nd:YAG laser alone, the topical cream containing Camellia reticulata and Radix Notoginseng in combination with the long-pulsed 1 064-nm Nd:YAG laser is more effective for the treatment of melasma, with higher patient satisfaction and less adverse reactions.

Key words: Chloasma, Laser therapy, Treatment outcome, Long-pulsed 1 064-nm Nd:YAG laser, Camellia reticulata, Radix Notoginseng, Combination therapy