Low-Fluence Q-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser for Melasma with Pre- or Post-Treatment Triple Combination Cream

Jeong, Seo Young; Shin, Jae Bin; Yeo, Un Cheol; Kim, Won Serk; Kim, Il Hwan

doi:10.1111/j.1524-4725.2010.01523.x

Cited by 95 publications

(113 citation statements)

References 25 publications

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“…They reported better subjective results on the side that had received laser therapy after topical treatment. 10 In another splitface study, Wattanakrai et al compared 5 session of weekly QSEYL and 2% hydroquinone (laser group) with topical therapy (control) in Asian patients with dermal or mixed-type melasma. According to modified MASI score and photometric assay, they found significant improvement in the laser-treated side; however, they reported complications such as melasma recurrence, rebound hyperpigmentation, and hypopigmentation in follow-up.…”

Section: Discussionmentioning

confidence: 99%

Combination of Q-Switched Nd:YAG and Fractional Erbium:YAG Lasers in Treatment of Melasma: A Randomized Controlled Clinical Trial

et al. 2017

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Introduction: Ablative and nonablative lasers have been used to treat melasma. We aimed to assess and compare the combining Q-switched Nd:YAG laser (QSNYL) and fractional erbium:YAG laser (FEYL) with QSNYL alone in treatment of melasma. Methods: This randomized controlled clinical trial was performed in our Research Center during 2013-2014. Women with melasma and without a history of keloid formation, hypersensitivity to hydroquinone, or pigmentary changes due to laser therapy were randomly allocated to receive four sessions of either QSNYL-FEYL combination or QSNYL alone. All patients received topical treatment with Kligman's formula. Before laser therapy and 4 weeks after the last treatment session, patients' skin was assessed for changes in skin color, melanin content, and erythema intensity of melasma lesions quantitatively. ; P < 0.001). After adjustment for baseline values, the post treatment intensity of erythema was significantly lower in QSNYL-FEYL group (P < 0.001). The patients reported no adverse events. Conclusion: QSNYL-FEYL was significantly more effective in decreasing melanin content of lesions than QSNYL and led to a lighter skin.

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Section: Discussionmentioning

confidence: 99%

Combination of Q-Switched Nd:YAG and Fractional Erbium:YAG Lasers in Treatment of Melasma: A Randomized Controlled Clinical Trial

et al. 2017

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“…Jeong and co-workers performed a split-face crossover study on 13 patients of Fitzpatrick phototypes III and IV where Q-switched (QS) 1064-nm laser therapy (7 mm, 1.6-2.0 J/cm 2 and 2 passes) was contrasted with pre-or post-treatment with triple combination (TC) cream (4% hydroquinone, 0.05% Tretinoin, and 0.01% fluocinolone acetonide). The authors noticed that when laser treatment was used after eight weeks of topical treatment, better results than before were obtained [18] . Wattanakrai and co-workers developed a split-face trial on 22 patients with dermal-or mixed-type melasma, in which they compared treatment using sub-thermolytic QSNY and topical 2% hydroquinone with treatment using 2% hydroquinone alone.…”

Section: Q-switched Lasersmentioning

confidence: 99%

Energy-based devices for treatment of melasma

Jordão

Rebellato

2017

J Surg Dermatol

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Melasma, as a pigmentation disorder, induces significant stress to the patients and its recurrent nature remains a challenge in clinical practice. Treatment is based on a variety of mechanisms to prevent and/or stop the pigment production process by destroying the deposited pigment for removal or release, by peeling cells to improve their turnover, and by reducing inflammation. The use of appropriate devices and correct settings are crucial in the treatment of melasma. Cases unresponsive to topical bleaches or chemical peels should be referred for laser therapy. It is important that a maintenance therapy to avoid the recurrence of melasma be indicated. In this paper, we review energy-based devices for melasma treatment.

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“…Several studies reported good improvement of melasma [68][69][70][71], especially when patients were pretreated with TCC [72] or when combined with glycolic acid peels [73], IPL [74] or dermabrasion [75]. However, reports of patients developing spotty hypopigmentation, depigmentation, leukotrichia, rebound hyperpigmentation and recurrence of melasma are noteworthy especially with too frequent (weekly) and too many sessions (>6-10) [71,76,77].…”

Section: Other Botanicals As Potential Bleaching Agentsmentioning

confidence: 99%

“…Different topical therapy combinations have been studied and combining topical, oral therapies with each other and/or with peeling and light therapies add to the efficacy of treatment especially in recalcitrant cases. Starting by TCC before other treatment modalities decrease the incidence of PIH and may decrease melasma relapse [54,61,72,74,75,79,83,89,99].…”

Section: Combination Therapymentioning

confidence: 99%

Melasma, Novel Treatment Modalities

Abdallah¹

2014

Pigmentary Disorders

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Treatment of melasma remains challenging due to frequent relapses and the occurrence of post-inflammatory hyperpigmentation (PIH) following many interventions. Treatment goals are inhibition of melanin synthesis and transfer by sunscreens, sun avoidance and the use of bleaching agents on one hand and removal of already present pigment by peeling, lasers and light on the other hand. Triple combination creams (TCC) (also known as Kligman's formula utilizing hydroquinone and modifications of Kligman's formula) remain the mainstay of treatment. Newer bleaching agents derived from plants and synthetic compounds have been introduced and many of them are promising safe substitutes for hydroquinone.Peeling agents especially superficial and medium depth peels are effective treatment modalities for melasma. Newer peeling agents are less irritating and may thus lead to fewer side effects. Q-switched lasers, which target melanin, have led to PIH until the innovation of "laser toning" and fractional Qswitched ruby, which have better outcomes. Fractional non-ablative and ablative lasers are useful at lower fluencies. Pulsed dye laser, which targets the vascular component in melasma, is promising with less melasma rebound.Combinations of the above-mentioned modalities usually have a better treatment outcome than either alone. This review will focus on the more recently introduced therapies.

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Low-Fluence Q-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser for Melasma with Pre- or Post-Treatment Triple Combination Cream

Abstract: Laser treatment after topical TC cream was found to be safer and more effective than the post-treatment use of topical agents.

Cited by 95 publications

References 25 publications

Combination of Q-Switched Nd:YAG and Fractional Erbium:YAG Lasers in Treatment of Melasma: A Randomized Controlled Clinical Trial

Combination of Q-Switched Nd:YAG and Fractional Erbium:YAG Lasers in Treatment of Melasma: A Randomized Controlled Clinical Trial

Energy-based devices for treatment of melasma

Melasma, Novel Treatment Modalities

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