Tian Yanli: Treatment of Melasma Using Fotona 1064nm Laser
Melasma is a human melanogenesis dysfunction that results in localized, chronic acquired hyper- pigmentation of the skin. It has a significant impact on appearance, causing psychosocial and emotional distress, and reducing the quality of life of the affected patients. Melasma presents a significant challenge to laser surgeons. Aggressive treatments often result in rebound melasma or post-inflammatory pigmentary alteration. Recent reports suggest melasma pathogenesis may have a vascular component. For certain patients identified by spectrocolorimetry, effective melasma treatment may include vascular-targeted therapy together with pigment-specific treatment modalities. Such combined therapies may reduce the likelihood of melasma recurrence.
Results: Two patients demonstrated greater than 50% improvement in melasma presentation. The improvement in melasma generally paralleled improvement in erythema. Post-inflammatory changes, or adverse events were noted.
Conclusions: Melasma lesions exhibiting subtle or sub-clinical telangiectatic erythema may be improved by combined vascular-targeted laser therapy together with LP Nd:YAG laser therapy. There is a low risk of adverse effects and overall patient satisfaction is high. Follow-up to optimize treatment parameters and determine long-term durability is needed.