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.
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