Melasma (Chloasma) (Mask of Pregnancy): Laser Treatment

Two things to know for melasma (chloasma, mask of pregnancy)

• initial treatment consists of topical application (in addition to sun protection):

1. The use of hydroquinone creams combining Vitamin-A-steroids makes the laser treatment more effective if it has not been used.
2. It is advisable to use a topical treatment as much as possible before using the laser, it is not only very expensive but the results often do not follow.

• no known cure

1. some studies show an improvement with pigment laser (low fluence (“laser toning”), NdYAG 1064nm). BUT these studies demonstrated the frequent occurrence of post-inflammatory hyperpigmentation and all patients had a recurrence of melasma.
2. IPL (flashlamp, Intense-Pulsed Light): response rate of 51% to 100% in more half of the treated patients after 4 treatments spaced 3 weeks. But in reality it is not so effective according to our experience and other studies show this. Also Negishi et al. reported worsening with the appearance of epidermal melasma in places clear of lesions before treatment.
3. Fractional laser: studies show good responses shown after 3 treatments. However in our experience, the results are not confirmed in reality and the risk of post-inflammatory hyperpigmentation amounts to  20% of treated patients *

• *Patients are not going to be happy if the treatment of hyperpigmentation results in even more hyperpigmentation!
• Source of information: 2012 (02) – 20th Regional Conference of Dermatology (RCD) – Manila, Philippines
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