Treatment of refractory dermal melasma with the MedLite C6 Q‐switched Nd:YAG laser: Two case reports

Polnikorn, Niwat

doi:10.1080/14764170802179687

Cited by 92 publications

(86 citation statements)

References 12 publications

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“…3 Recently, a 1064-nm Q-switched neodymium-yttriumaluminum-garnet (Nd:YAG) laser with low energy was introduced for the treatment of melasma in Asian patients, with favorable results. [4][5][6] Patients experienced minimal downtime without crust formation and significant erythema after laser treatment. Notwithstanding, the possibility of rebound hyperpigmentation (RH) and punctate leukoderma have since been found to be the major concerns for this treatment.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Efficacy and Safety of Invasive Pulsed-Type Bipolar Alternating Current Radiofrequency on Melasma and Rebound Hyperpigmentation

Kim¹,

Lee²

2017

Medical Lasers

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Background and ObjectivesLaser treatment for melasma is typically associated with various complications, especially rebound hyperpigmentation (RH) and mottled hypopigmentation. The purpose of this case review was to analyze the clinical efficacy and safety of using an uinvasive pulsed-type bipolar alternating current radiofrequency (IBPRF) for treating melasma with or without RH. Materials and MethodsClinical improvement in the appearances of melasma and RH was analyzed in 142 Korean patients (4 men and 138 women, with a mean age of 37.3 ± 11 years), who had undergone IBPRF treatment for melasma. IBPRF was delivered at a frequency of 2 MHz and with non-insulated, penetrating microneedles over five to 10 treatment sessions at 2-to 3-week intervals. ResultsIn total, 124 patients had melasma, and among them,18 patients had melasma with RH. To treat melasma, IBPRF alone was administered to 112 subjects, IBPRF plus a Q-switched Q-switched neodymium-yttriumaluminum-garnet (Nd:YAG) laser in 22 patients, IBPRF plus intralesional tranexamic acid injection in five patients, and IBPRF plus bleaching cream in three patients. Patients reported subjective satisfaction with the appearance of their melasma lesions after seven to eight treatment sessions, regardless of whether they underwent treatment with pulsed RF alone or combination treatment. After treatment, no significant complications, particularly RH or mottled hypopigmentation, were recorded. ConclusionNo severe complications related to IBPRF treatment were recorded, and patients reported satisfaction in the appearance of their lesions after seven to eight treatment sessions. This suggests that IBPRF may be effective and safe for treating melasma and RH. Key words

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Section: Introductionmentioning

confidence: 99%

Therapeutic Efficacy and Safety of Invasive Pulsed-Type Bipolar Alternating Current Radiofrequency on Melasma and Rebound Hyperpigmentation

Kim¹,

Lee²

2017

Medical Lasers

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“…If the outcome of the second line treatments is not satisfactory then the third line treatment would be considered which includes light based and fractional laser therapies. Recently the subthermolytic Q-switched Nd Yag laser therapy has been widely used because of its efficacy and safety even in Asian patients with darker skin tone (15). Although subthermolytic Q-switched 1064nm Nd Yag laser therapy has shown promising results, this treatment would require multiple sessions on a weekly basis, which would burden the patients (16,17).…”

Section: Introductionmentioning

confidence: 99%

Response to Intradermal Autologous Platelet Rich Plasma Injection in Refractory Dermal Melasma: Report of Two Cases

Amini

Ts²,

Ch³

2015

JUMMEC

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Refractory dermal melasma is resistant to conventional treatment. Platelet rich plasma (PRP) may help to reduce the pigmentation of melasma. We present a case report on the clinical outcome of 2 patients with melasma, given PRP, as an adjunct therapy. PRP was administered at a monthly interval for 2 sessions in combination with a monthly Q-switched Nd Yag laser treatment and topical alpha arbutin application. A modified melasma area and severity index (MASI) was evaluated by two dermatologists who were blinded. At the follow up on the 3 rd months, the MASI score was reduced by mean 33.5% for case 1 and 20% for case 2. There were no clinical complications for case 1. However recurrence of melasma was noted in case 2 by a worsening of the MASI score mean to 53% at the sixth months follow up. In conclusion, intradermal PRP injection as an adjunct to the conventional treatment of melasma presented with differing results in two cases.

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“…[7][8][9][10][11] These studies that focus on the risk of hypopigmentation related with laser toning therapy were published in the years of 2008-2010. Laser toning started being widely used slightly before this period which means that the studies were conducted while the treatment method was still in its early stage.…”

Section: Studies That Warn Against Laser Toning Emphasize the Risk Ofmentioning

confidence: 99%

“…Such an overblown fear may have stemmed from several reports such as case series of facial depigmentation associated with low fluence Q-switched 1,064 nm Nd:YAG laser for skin rejuvenation and melasma which emphasized the risk of hypopigmentation with laser toning, questioning the appropriateness of using laser toning in the treatment of melasma. [7][8][9][10][11] Various studies have pointed out that laser toning is associated with a high incidence of hypopigmentation. We would like to share our clinical experiences and include a literature review regarding whether hypopigmentation is truly a catastrophic and unavoidable complication of laser toning.…”

Section: Introductionmentioning

confidence: 99%

Mottled Hypopigmentation from Laser Toning in the Treatment of Melasma: A Catastrophic or Manageable Complication?

Park

Yeo²

2015

Medical Lasers

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Melasma is a common acquired pigmentary disorder and difficult to treat with a high rate of recurrence. Conventional methods in the treatment of melasma have drawbacks and limitations. The so-called "laser toning" treatment, which uses a collimated low-fluence 1,064 nm Q-switched neodymium-doped yttrium aluminum garnet laser, was introduced a few years ago for the treatment of melasma. Laser toning has attracted much popularity and attention, and has become a crucial method for treatment of melasma. Laser toning is now a mainstay for treatment and management of melasma, however some dermatologists have excessive concerns about the risk of hypopigmentation. This inordinate fear may have originated from a few studies which insisted that laser toning therapy has a high risk of hypopigmentation and should be considered as a second-line treatment, not a first-line treatment for melasma. In the current study, we suggest that hypopigmentation after laser toning is a preventable and controllable complication based on our clinical experiences and reviews of various literatures. Key words

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Treatment of refractory dermal melasma with the MedLite C6 Q‐switched Nd:YAG laser: Two case reports

Abstract: Even in cases of long-standing refractory dermal melasma in a darker skin type, combination therapy has been shown to be an effective treatment for this difficult condition.

Cited by 92 publications

References 12 publications

Therapeutic Efficacy and Safety of Invasive Pulsed-Type Bipolar Alternating Current Radiofrequency on Melasma and Rebound Hyperpigmentation

Therapeutic Efficacy and Safety of Invasive Pulsed-Type Bipolar Alternating Current Radiofrequency on Melasma and Rebound Hyperpigmentation

Response to Intradermal Autologous Platelet Rich Plasma Injection in Refractory Dermal Melasma: Report of Two Cases

Mottled Hypopigmentation from Laser Toning in the Treatment of Melasma: A Catastrophic or Manageable Complication?

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