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IMCAS Asia 2021
Program

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FOCUS ON S07 - ROUNDTABLE

Pigmentation & melasma

Room: Channel 2
Date: Saturday 10 July 2021 at 14:00 to 15:30
Format: ROUNDTABLE > short presentations followed by a structured discussion between experts and chairs

Chairs

Prof Hin Lee Henry CHAN

Dermatologist

Hong Kong SAR China

Dr Chung Jen Edward TSENG

Dermatologist

Taiwan

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
14:00		Welcome by Chairs		111762
14:02	Prof Hin Lee Henry CHAN	Recent advances in treatment of pigmentary condition	View	110256
14:14	Dr Ayaka NISHIKAWA	The safety and efficacy of fractional RF microneedling device with repeated short pulses for the treatment of melasma	View	109885
14:26	Dr Peter Wee Beng CH ' NG	Laser in melasma: friend or foe?	View	109538
14:38	Dr Chang Cheng Charlie CHANG	Evolution for melasma treatment with laser: from laser toning to photoaging reversal	View	109534
14:50	Dr Kiran GODSE	Updating approach to melasma	View	109123
15:02	Dr Khalil KHATRI	CO2 laser and drug delivery to treat melasma	View	109438
15:14		Chairs questions to speakers		109539
15:24		Q&A with the audience		109540

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Melasma

Pigmentation

Lasers

Energy-based devices (EBD)

Radiofrequency (RF)

Welcome by Chairs

Prof Hin Lee Henry CHAN

Dermatologist

Hong Kong SAR China

Other author(s) :

Recent advances in treatment of pigmentary condition

Objectives: Lasers have been used for the treatment of epidermal pigmentation but can be associated with complications such as PIH. Melanocytes are known to be very susceptible to cryoinjury, however such injury is typically reported after application for cryosurgery and results in long lasting depigmentation and side effects. The dosimetry and role of controlled skin cooling on epidermal pigmentation deserves further investigation. The use of controlled cooling to reduce epidermal pigmentation and focused laser for dermal pigmentation will also be discussed.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Ayaka NISHIKAWA

Dermatologist

Japan

Other author(s) :

The safety and efficacy of fractional RF microneedling device with repeated short pulses for the treatment of melasma

Objectives: To investigate the safety and efficacy of invasive micro-pulsed electric signal device for treatment of melasma.

Introduction: Melasma is a common disorder of hyperpigmentation in Asian women with Fitzpatrick skin phototypes III or higher. Conventional micro-needling treatment is generally avoided in the melasma area because it may aggravate the melasma. Fractional RF micro-needling devices using a micro-pulsed electric signal can approach the basement membrane and vascular endothelial growth factor (VEGF) to improve melasma. We investigated whether micro-pulsed electric signal device can be used safely and effectively for Asian patients with melasma.

Materials / method: 28 female patients and 1 male patient (Fitzpatrick skin type III–IV) were treated using micro-pulsed electric signal device. Five treatments were administered at 2-weeks intervals. The power levels ranged from 3 to 4, depth 0.8 mm to 1.5 mm, and single pass. Photographs were taken at the beginning and 1 month after the last treatment. Low-fluence Q-switched Nd:YAG laser was not used during the evaluation period.

Results: No adverse events including melasma worsening were noted. The average score in skin analysis device improved in all of the following categories: melanin, hemoglobin, wrinkles, and pores. However, only 30% cases were diagnosed by physicians as the significant improvement in melasma.

Conclusion: This device has a rejuvenation effect on the skin, helps with vascular disorders, and can be used safely with patients with melasma. The therapeutic effect for melasma might be based on the approach with tranexamic acid medication and low-fluence Q-switched Nd:YAG laser rather than this device alone. In the future, we would like to study the therapeutic effects of this device in combination with low-fluence Q-switched Nd:YAG laser.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Peter Wee Beng CH ' NG

Dermatologist

Malaysia

Other author(s) :

Laser in melasma: friend or foe?

Objectives: Melasma is an acquired hyperpigmentation disorder with symmetrical distribution over the face. It is still one of the most difficult hyperpigmentation disorders to treat. In this lecture I’ll discuss about the different types of lasers that can be used to treat melasma and also the possible complications associated with their use.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Chang Cheng Charlie CHANG

Plastic Surgeon

Taiwan

Other author(s) :

Evolution for melasma treatment with laser: from laser toning to photoaging reversal

Objectives: To know the update concepts for melasma treatment with Llaser application

Introduction: Melasma is caused by not only over production of melanin but hyperactivity of melanocytes, which usually recurs and leads to post-inflammatory hyperpigmentation (PIH) after aggressive treatment.

Materials / method: We advocate a melasma treatment evolution in Asians based on not only our experiences but statistic records. They typically begin with topical agents. The US Food and Drug Administration has approved a modified combination of the Kligman formulation, containing 4% hydroquinone, 0.05% tretinoin and 0.01% fluocinolone ace- tonide, for melasma treatment.

Results: For laser therapy, the depigmentation is usually the main purpose for melasma patients in Asia. The Nd:YAG non-ablative laser toning has been popularized for facial rejuvenation. However, some side effects such as post-inflammatory hyperpigmentation (PIH) and the flaring-up are issues of concern to Asian patients. We had ever investigated the role of vitamin C application by sonophoresis in the prevention of side effects in Asian patients’ post-Nd:YAG therapy.

Conclusion: In the new era for picosecond laser, We have demonstrated the series of studies from Nd-yac Q switch laser to advanced pico-second laser combined with focus lens array in our team. Whether three or five of picosecond 755-nm alexandrite laser with a diffractive lens array, as well as triple combination cream, can demonstrated a great efficacy for melasma treatment in Asian patients. The improvement in wrinkles, texture, pores, UV spots, brown spots, especially in spots and porphyrins were also observed with VISIA imaging analysis.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Kiran GODSE

Dermatologist

India

Other author(s) :

Updating approach to melasma

Objectives: Melasma is an acquired, chronic pigmentary disorder predominantly affecting women. It may significantly affect quality of life and self-esteem of person while facing others.

Introduction: Hydroquinone is considered Gold standard in melasma treatment.
Triple combination cream is the most effective and well-studied treatments for melasma. Peels and lasers are third line approach for melasma.
In dark skin laser treatment may have rebound pigmentation.
Oral tranexamic acid is safe, systemic adjunctive treatment for melasma.

Materials / method: There is a paucity of well-designed RCTs evaluating the safety and efficacy of this regimen as maintenance therapy and duration of treatment in Indian population.

Mometasone based triple combination creams leads to the rapid lightening of pigmentation , but the relapse is also very fast. Further worsening of pigmentation and increase in the area of the original lesion has also been experienced by both the patients and physicians. Long-term use is invariably associated with topical
side effects such as erythema and thinning of skin.

Conclusion: Medical management of melasma with topical skin lightening therapy still remains the mainstay of therapy and should always be used as first-line agents. HQ, triple combination therapy, other agents and upcoming oral therapies will be used in combination in the future.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Khalil KHATRI

Dermatologist

United States

Other author(s) :

CO2 laser and drug delivery to treat melasma

Objectives: Explore the possibility of new treatments for Melasma

Introduction: Melasma is chronic skin discoloration of the face of a significant number female patients, majority of them are darker skin

Materials / method: 32 to female patients of skin type I-IV were treated with Fractional Ablative CO2 Laser. Tri-Luma or 4% Hydroquinone cream was applied and rubbed immediately after Laser treatment. Patients started to apply the topical creams one week after the Laser treatment. Patients were followed 1 week, 1 month,, 3 months and 6 months after the treatment

Results: 3 blinded laser dermatologists evaluated and graded the photos and results showed 52% improvement in Melasma and 54% improvement in skin texture

Conclusion: A single CO2 Fractional Laser and Tri-Luma/4% HQ cream +/- oral TXA using drug delivery protocol to treat Melasma is safe and effective for the follow up period of up to 6 months

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

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IMCAS Asia 2021 Program

FOCUS ON S07 - ROUNDTABLE

Pigmentation & melasma

Chairs

Lectures of the session

Recommended sessions

IMCAS Asia 2021
Program