Fractional Lasers to treat Melasma ?

The efficacy in melasma treatment using a 1410 nm fractional photothermolysis laser.
Wanitphakdeedecha R, Keoprasom N, Eimpunth S, Manuskiatti W.
J Eur Acad Dermatol Venereol. 2014 Mar;28(3):293-7. doi: 10.1111/jdv.12100. Epub 2013 Jan 24.

• Melasma (Chloasma, Pregnancy Mask) is a hyperpigmentary dermatosis which is more prevalent in darker phototypes as well as in higher UV environments.
• It is hard to treat despite sometimes effective topical treatments (superficial melasma), oral treatments (tranexamic acid) and IPL (dermal melasma). The problem is that despite it fading, it tends to come back and only sunprotective habits can slow down the recurrence.
• This study shows interesting results for the 1410nm fractional photothermolysis laser:
  • 30 patients were treated monthly for 5 months: 20mJ at 20% coverage on one side and 20mJ at 5% coverage on the other side (4 passes on the entire face and 4 passes on the melasma area).
  • results were assessed 1,2 and 3 months after the treatments.
• Results showed:
  • improvement of the Melanin index, Visual Analog Scale and Melasma Area and Severity Index (MASI)
  • Adverse reactions: post inflammatory hyperpigmentation, redness, and dryness as adverse reactions (all more frequent at 20% coverage).

• Limitation: long-term assessment for recurrence was not done.

Contributors

Dr Christophe Hsu – dermatologist. Geneva, Switzerland