New insight in the treatment of refractory melasma: Laser Q-switched Nd: YAG non-ablative fractionated followed by intense pulsed light

Cunha, Paulo Rowilson; Pinto, Clóvis Antônio Lopes; Mattos, Camila Bonati; Cabrini, Dayane Peverari; Tolosa, Joana Lugli

doi:10.1111/dth.12250

Cited by 11 publications

(5 citation statements)

References 16 publications

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“…Cunha et al [45] studied six patients of refractory melasma with the combination of IPL with toning at a monthly interval and reported significant improvement in all the patients. Similar results were also reported by Yun et al [46] in 12 Korean patients treated with fractionated IPL and laser toning.…”

Section: Combination Therapymentioning

confidence: 99%

Laser toning in melasma

Shah¹,

Aurangabadkar

2019

J Cutan Aesthet Surg

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Melasma is a common acquired disorder of hyperpigmentation. A variety of treatment options has been suggested for the management of melasma. A range of different lasers had been tried in the treatment of melasma. Q-switched Nd-YAG laser (QSL) is the most commonly used laser in the treatment of melasma. Recently, laser toning or low-fluence, multi-pass technique has become popular in treatment of melasma. Authors aimed to review the procedure, its effectiveness, combination therapies using laser toning, and complications of laser toning. A PubMed search was made using keywords such as laser toning, QSL, melasma, and lasers in melasma, and relevant articles were reviewed.

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Section: Combination Therapymentioning

confidence: 99%

Laser toning in melasma

Shah¹,

Aurangabadkar

2019

J Cutan Aesthet Surg

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“…The literature suggests that combinations of lasers, such as 1064 nm Q-switched Nd:YAG with pulsed dye laser (PDL), IPL, and radiofrequency are superior to single laser therapy in efficacy and sustained effect [129][130][131]. However, meta-analyses acknowledge a higher incidence of adverse effects with combination therapy [129].…”

Section: Low-fluence Qs Nd:yagmentioning

confidence: 99%

An Update on New and Existing Treatments for the Management of Melasma

Gan,

Rodrigues

2024

Am J Clin Dermatol

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Melasma is a chronic, acquired disorder of focal hypermelanosis that carries significant psychosocial impact and is challenging for both the patient and the treating practitioner to manage in the medium to long term. Multiple treatments have been explored, often in combination given the many aetiological factors involved in its pathogenesis. Therapeutic discoveries to treat melasma are a focal topic in the literature and include a range of modalities, with recent developments including updates on visible light photoprotection, non-hydroquinone depigmenting agents, oral tranexamic acid, chemical peels, and laser and energy-based device therapy for melasma. It is increasingly important yet challenging to remain up-to-date on the arsenal of treatments available for melasma to find an efficacious and well-tolerated option for our patients. Supplementary Information The online version contains supplementary material available at 10.1007/s40257-024-00863-2.

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“…Since there is no cell death and skin heating is kept to a minimum, the risk of melasma exacerbation is much lower. This technique achieved the best results and the lowest risk of recurrence when it is combined with other agents such as topical HQ [199,200], triple combination cream [201], azelaic acid [202], chemical peels, e.g., Jessner's formula [203,204], GA [205,206] and systemic treatment with TA [199,[207][208][209][210], as well as other treatment procedures, such as microneedling with ascorbic acid [211], microneedle radiofrequency (RF) [212], microdermabrasion [213], pulsed-dye laser [214], and IPL [188,215,216]. In each of these cases, combination therapy was more effective than the laser toning procedure alone [197,217].…”

Section: Laser Therapymentioning

confidence: 99%

Understanding Melasma-How Can Pharmacology and Cosmetology Procedures and Prevention Help to Achieve Optimal Treatment Results? A Narrative Review

Piętowska

Nowicka

Szepietowski

2022

IJERPH

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Melasma is a chronic skin condition that involves the overproduction of melanin in areas exposed to ultraviolet radiation. Melasma treatment is long-term and complicated with recurrence and resistance to treatment. The pathogenesis of melasma is highly complex with multiple pathologies occurring outside of the skin pigment cells. It includes photoaging, excessive melanogenesis, an increased number of mast cells, increased vascularization, and basement membrane damage. In addition, skin lesions related to melasma and their surrounding skin have nearly 300 genes differentially expressed from healthy skin. Traditionally, melasma was treated with topical agents, including hydroquinone, tretinoin, glucocorticosteroids and various formulations; however, the current approach includes the topical application of a variety of substances, chemical peels, laser and light treatments, mesotherapy, microneedling and/or the use of systemic therapy. The treatment plan for patients with melasma begins with the elimination of risk factors, strict protection against ultraviolet radiation, and the topical use of lightening agents. Hyperpigmentation treatment alone can be ineffective unless combined with regenerative methods and photoprotection. In this review, we show that in-depth knowledge associated with proper communication and the establishment of a relationship with the patient help to achieve good adherence and compliance in this long-term, time-consuming and difficult procedure.

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New insight in the treatment of refractory melasma: Laser Q-switched Nd: YAG non-ablative fractionated followed by intense pulsed light

Cited by 11 publications

References 16 publications

Laser toning in melasma

Laser toning in melasma

An Update on New and Existing Treatments for the Management of Melasma

Understanding Melasma-How Can Pharmacology and Cosmetology Procedures and Prevention Help to Achieve Optimal Treatment Results? A Narrative Review

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