Heal House Vitiligo Research 25 · Original Article
How effective are PALLAS laser and excimer laser for vitiligo?
Comparison of 311-nm Titanium:Sapphire laser and 308-nm excimer laser treatment for vitiligo: A randomized controlled non-inferiority trial
In short
The newer PALLAS laser was as effective and safe as the current standard excimer laser. This adds one more treatment option for vitiligo.
When a new device comes out, we always wonder how closely its 'advertising claims' match its 'actual performance.' The standard treatment for repigmenting vitiligo is the excimer laser. There were expectations that the new PALLAS laser (311 nm) would be equally effective. The problem was that these were only expectations, and there were almost no head-to-head comparison data between the two lasers. So we decided to test whether those expectations held up by pitting them directly against each other.
Q1 How Were the Two Lasers Compared Fairly?
We divided symmetrical lesions on the same patient, one side to each laser. One side was treated with the excimer laser, the other with the PALLAS laser. Comparing lesions on the same person automatically controls for factors like age and skin characteristics. This allows a clean look at the pure difference in treatment effect. Which side received which laser was determined randomly, like drawing lots, to prevent biased results. We treated 74 pairs of symmetrical lesions in 21 patients with stable vitiligo twice a week for 12 weeks, and carefully assessed repigmentation every 4 weeks.
Study at a Glance
| Item | Content |
|---|---|
| Target | 21 patients with stable vitiligo (74 pairs of symmetrical lesions) |
| Methods | Left and right lesions of the same patient randomly assigned to the two lasers |
| Treatment | Twice a week, for 12 weeks |
| Difference in efficacy | Approximately 2.9 percentage points between the two lasers (essentially no difference) |
| Safety | No serious adverse events with either laser |
Q2 What Were the Results?
The difference in repigmentation between the two lasers was only an average of 2.9 percentage points. This is essentially a negligible difference. It fell well within the margin I had predefined (10 percentage points), allowing us to conclude that the PALLAS laser is not inferior to the excimer laser. Neither laser caused any serious adverse events. In terms of both efficacy and safety, the new laser was not inferior to the standard treatment. In simple terms, you can expect similar results regardless of which laser is chosen.
Closing remarks
This was confirmed through a randomized clinical trial, the most rigorous method. So we can confidently say that 'the PALLAS laser is as reliable as the excimer laser.' This means treatment options can be chosen more flexibly based on the location and condition of your lesions and the equipment available at the clinic. A wider range of choices means we can offer appropriate treatment to more patients.
