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Efficacy of 577 nm pro-yellow laser in the treatment of melasma: a prospective split-face study
摘要： We aimed to study the effectiveness of 577 nm pro-yellow laser in the treatment of melasma. A total of 82 patients with melasma were included in this comparative study. A detailed medical history, examination, and calculation of Melasma Area and Severity Index were done for all patients. All participants were treated with topical sunscreen and hydroquinone 4% cream on both sides of the face. In addition, the left side of the face was subjected to a single pass of 577-nm pro-yellow laser at a monthly interval for three sessions. Follow up was done by comparing the Melasma area and severity index at 0, 3 and 6 months. At baseline, there is no significant difference in the Melasma area and severity index score between both sides of the face. At 3 months, MASI score was statistically significantly decreased on both sides of the face compared to pretreatment (P < .05). At 6 months, the mean MASI score at the laser-treated side was statistically significantly decreased compared to the non-laser-treated side (P < .05). we concluded that the addition of 577 nm pro-yellow laser in the treatment of melasma leads to maintain the improvement and reduction of the recurrence rate.
关键词： Melasma,hydroquinone cream,pro-yellow laser
更新于2025-09-23 15:21:01
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Clinical improvement of photoaging-associated facial hyperpigmentation in Korean skin with a picosecond 1064-nm neodymium-doped yttrium aluminum garnet laser
摘要： Traditional attempts at alleviating photoaging-associated facial pigmentation conditions such as melasma, mottled hyperpigmentation, and post-inflammatory hyperpigmentation have yielded disfiguring cosmetic results. Laser toning using a low-fluence Q-switched 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser has been more commonly applied to date. However, the treatment efficacy and safety of this approach have not been widely reported. This study therefore evaluated the efficacy and safety of picosecond 1064-nm Nd:YAG laser application for photoaging-associated facial pigmentation treatment in Korean subjects. Forty-seven Korean subjects with photoaging-associated facial pigmentation underwent picosecond 1064-nm laser application. The clinical improvement of 17 patients was assessed by objective measurements such as melanin and erythema indices. All subjects received six biweekly treatments with the laser in a three-pass fashion delivering approximately 2000 to 2500 shots using a zoom handpiece with a spot size of 7 mm, fluence ranging from 0.4 to 0.7 J/cm2, and a repetition rate of 10 Hz. Clinicians evaluated the improvement of pigmentation using the pigmentation area and severity index (PSI), and subjects reported their satisfaction level on a four-point scale. Statistical analyses were performed using the SPSS version 19.0 for Windows software program (IBM Corp., Armonk, NY, USA). Forty-seven subjects (45 females and two males) completed this study with a 12-week follow-up period. The average decrease in PSI value at 12 weeks after treatment was 6.85 ± 6.35 points (p < 0.001). The average decreases in the values of the erythema and melanin indices were 19.41 ± 64.64 points (p = 0.234) and 28.88 ± 32.89 points (p = 0.002). An analysis of 32 subjects’ reports (68.1%) suggested good or excellent improvement. No serious adverse effects were observed during treatment or the follow-up period. Picosecond 1064-nm Nd:YAG laser application appears to be safe and effective in improving various photoaging-associated facial pigmentation conditions in Korean skin.
关键词： Melasma,pigmentation,Aging,Picosecond laser,Skin
更新于2025-09-23 15:19:57
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Clinical & ultrastructural evaluation of the effect of fractional CO2 laser on facial melasma
摘要： Melasma represents the most obvious and disfiguring change of the face leading to psychological problems especially in females. Ablative lasers have also been used by many professionals to treat melasma, although there is few scientific data supporting this indication. The exact mechanism of action of ablative lasers in melasma is not yet clear enough. We aimed to evaluate the ultra- structural effect of fractional ablative CO2 (FrCo2) laser on facial melasma. Eleven melasma patients evaluated clinically by clinical modified area and severity index (MASI) score, treated by two sessions of fractional CO2 laser one month a part. Two punch biopsies of 2 mm diameter were obtained from all subjects one before and the other 3 months after treatment. All biopsies were analyzed by light and electron microscopy. Clinically, significant improvement of pigmentation and 48% reduction of (MASI) score were observed after two sessions of laser treatments. Light microscopic analysis of specimens revealed significant decrease in melanocyte count after treatment. Electron microscopic analysis of specimens after treatment revealed significant decrease in the number and size of melanocytes and significant decrease or complete absence of melanin granules in the surrounding keratinocytes compared to pre-treatment specimens. No scarring or post inflammatory hyper or hypopigmentation. We concluded that repeated application of Fractional CO2 laser on melasma skin may result in long lasting improvement due to its destructive effect on melanocytes.
关键词： electron microscopy,Melasma,dermoscopy
更新于2025-09-16 10:30:52
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Clinical factors affecting the efficacy of melasma treatment using the Q-switched 1064 Nd: YAG laser mode in a group of Venezuelan female patients
摘要： The influence of melasma risk factors on the effectiveness of laser toning treatment in Venezuelan females was investigated. Clinical evaluation was performed (n = 64) including ultrasound and thyroid hormone profile. All patients underwent face exposure with laser toning, eight sessions weekly. VISIA percentiles corresponding to dark brown spots determined before and after treatment were compared by ANOVA. Differences between percentile values before and after treatment for each patient were calculated and expressed as percentages. An improvement of ≥30% was considered as significant. Spearman rank correlations between improvement and clinical parameters were determined. A significant increase (p > .005) of the median of the percentiles in the overall group was observed. However, only 62.5% of the patients exhibited an improvement of ≥30% at the right malar, 73.4% at the frontal and 71.8% at the left malar areas. Hormonal contraception during treatment (right malar: p < .0001 left malar: p = .0035), thyroid disorders (right malar: p < .0001; frontal: p = .011; left malar: p < .0001) and photoaging (right malar: p = .0235; frontal: p = .0237; left malar: p = .0137) were inversely associated to melasma improvement after treatment. Prolonged use of sunscreen improved significantly (right malar: p < .001; frontal: p = .016 and left malar: p = .025) treatment effectiveness.
关键词： thyroid disorders,photoaging,Melasma,laser toning,contraceptives
更新于2025-09-12 10:27:22
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Efficacy and safety of 1927 nm fractional Thulium fiber laser for the treatment of melasma: a retrospective study of 100 patients
摘要： Background: Melasma is an acquired hyperpigmentation of the skin that mostly affects areas exposed to the sun. The treatment of melasma can be challenging as it is prone to relapse. Recently, new laser and light-based treatment options have been used; one of these treatment modalities is the 1927 nm fractional Thulium fiber laser. Objective: This study aimed to retrospectively evaluate the efficacy and safety of a 1927 nm fractional Thulium fiber laser for the treatment of melasma. Materials and methods: This study retrospectively evaluated patients who were admitted to the dermatology outpatient clinic between September 2015 and March 2018 and treated with a 1927 nm fractional Thulium fiber laser. The MASI score was used to assess improvements of the lesions. Results: The current study included a total of 100 patients who received 1927 nm fractional Thulium fiber laser treatment. Each patient received two treatments at one month intervals. The mean baseline MASI score was 11.8 ± 6.3, the mean MASI score after the first session was 6.7 ± 4.1, and the mean MASI score after the second session was 3.4 ± 3.8. The differences between these three MASI scores were significant, and the laser treatment had no major side effects. Conclusion: Results of this study indicate that the 1927 nm fractional Thulium fiber laser is a safe and effective treatment option for melasma.
关键词： Melasma,1927 nm thulium fiber laser,fractional laser
更新于2025-09-12 10:27:22
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Q-PTP is an optimized technology of 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser in the laser therapy of melasma: A prospective split-face study
摘要： Quickly-pulse-to-pulse (Q-PTP) is the latest dual pulse mode Q-switched neodymium-doped yttrium aluminum garnet [QS Nd:YAG (QSNY)] laser technology that improves efficacy and minimizes side effects. In this study, the safety, efficacy, and advantages of Q-PTP and single-pulse laser mode of 1064-nm QSNY in the treatment of melasma were compared. Twelve healthy women were enrolled in this split-face study. Q-PTP and single-pulse laser mode of 1064-nm QSNY were applied to the treatment side and the control side, respectively. Physician's global assessment, patients' self-assessment and the modified melasma area and severity index (mMASI) scores were used to quantify pigmentation changes. Side effects were recorded. Mean mMASI scores were decreased significantly at the 4th and 12th-week follow-up visit compared to the baseline. Melasma lesion clearance was more than 50% in 58% of patients compared with the baseline. However, both sides of the same patient showed similar therapeutic effect. Minor pain experience and slighter skin erythema reaction were reported in Q-PTP laser mode treatment side compared with the control. No serious complications were found in any of the patients. Q-PTP laser mode of 1064-nm QSNY is an optimal laser therapy in the treatment of melasma with greater safety and superiority.
关键词： laser toning,Q-PTP,1064-nm QS-Nd: YAG laser,melasma
更新于2025-09-11 14:15:04
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Assessment of combined fractional CO <sub/>2</sub> and tranexamic acid in melasma treatment
摘要： Background: Melasma continues to be a disease that is difficult to treat with no fully satisfactory results. The role of a fractional CO2 laser in its treatment is controversial. The addition of tranexamic acid (TXA) might be helpful. Objectives: To assess the efficacy of a low-power fractional CO2 laser alone versus its combination with tranexamic acid used either topically or intradermally for melasma treatment. Methods: A randomized comparative split-face study included a total of thirty female patients with bilateral, symmetrical melasma. The whole face was subjected to treatment via a low-power (12 Watts) fractional ablative CO2 laser. One side was randomly assigned to topical application of tranexamic acid solution after the session immediately or intradermal microinjection of tranexamic acid prior to the laser session. Sessions were conducted every 4–6 weeks for five consecutive sessions. Assessments were done using the melasma area severity index MASI score, melanin index (MI), and erythema index (EI) before sessions and 2 weeks after the final session. Results: After treatment, there was significant reduction in the MASI score on both sides of the face; the side treated with the fractional CO2 laser alone and the side treated with fractional CO2 laser combined with TXA (topically or intradermal injection) (P-values 0.007, <0.001, and 0.016, respectively). MI was significantly lower on the side receiving fractional CO2 laser alone and the side receiving fractional CO2 laser combined with intradermal injection of TXA (P-values <0.001 and 0.003, respectively), while the EI showed significant improvement only on the side receiving fractional CO2 laser alone (P-value ? 0.023). Although patients reported no differences in improvement on either treated side, the degree of improvement regarding the MASI score was better on the side receiving fractional CO2 laser alone. Regarding MI, the degree of improvement was higher on the side receiving fractional CO2 laser combined with intradermal injection of TXA than on the side receiving fractional CO2 laser alone; however, this improvement did not reach statistical significance. Minimal complications occurred in the form of mild pain. Conclusion: A low-power fractional CO2 laser is an effective, safe treatment for melasma. However, the addition of tranexamic acid (either topically or intradermally) to a fractional CO2 laser should be further studied.
关键词： melasma,fractional CO2 laser,tranexamic acid
更新于2025-09-10 09:29:36
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In vivo multiphoton microscopy imaging of melasma
摘要： Melasma is a skin disorder characterized by hyperpigmented patches due to increased melanin production and deposition. In this pilot study we evaluate the potential of multiphoton microscopy (MPM) to characterize non-invasively the melanin content, location, and distribution in melasma and assess the elastosis severity. We employed a clinical MPM tomograph to image in-vivo morphological features in melasma lesions and adjacent normal skin in 12 patients. We imaged dermal melanophages in most dermal melasma lesions and occasionally in epidermal melasma. The melanin volume fraction values measured in epidermal melasma (14±4%) were significantly higher (p<0.05) than the values measured in peri-lesional skin (11±3%). The basal keratinocytes of melasma and perilesions showed different melanin distribution. Elastosis was predominantly more severe in lesions than in perilesions and was associated with changes in melanin distribution of the basal keratinocytes. These results demonstrate that MPM may be a non-invasive imaging tool for characterizing melasma. Identifying the depth of excess pigment is critical for successful treatment of melasma. Multiphoton microscopy demonstrates the ability to visualize non-invasively the melanophages, a sign of a prior inflammatory response, key in the differential diagnosis of melasma. Patients with melasma may be diagnosed more accurately using a rapid, label-free, non-invasive microscopy technique.
关键词： in vivo imaging,melasma,microscopy
更新于2025-09-09 09:28:46