摘要

Objectives: To evaluate the safety and efficacy of the new 675-nm wavelength in the management of mixed melasma, Introduction: Melasma is a chronic acquired hyperpigmentation disease that mainly affects women with various darker skin patterns. The higher melanin content in phototypes IV and V makes it difficult to carry out aesthetic procedures due to possible side effects. For the treatment of melasma, laser therapy represents a good alternative option compared with more usual therapies. The 675-nm laser targets melanin but does not interfere with the vascular component. The preclinical study showed that it acts on melanin to melanin, preserving skin structures. Materials / method: Our study included 15 patients (15 women) with facial melasma, of whom 9 were skin type IV and 6 were skin type V. The study protocol included up to three sessions of the 675- nm laser, with a 30-day interval between treatments. Parameters included power 3–5 W, dwell time 100–150 ms, spacing 0.5–1 mm, and cooling 5C (300–700 mJ @0.7 mm spot). Parameters were adapted to phototype with a reduction in energy to reduce the risk of postinflammatory hyperpigmentation. Standardized photography was obtained at baseline, at a 3-month follow-up. Results: For all patients, it was possible to evaluate skin improvement before and after the last treatment with 675-nm Laser. In general, at T1 a consistent improvement in the pigmentary and vascular components was visible. All patients tolerated treatment well. Most patients reported pain associated with the procedure as mild. Patient's skin improvement after a single session. A remarkable reduction of the entire diffused pigmentation. Furthermore, considering the outcomes achieved. All patients experienced enhancements in skin texture, thickness, brightness, and overall skin health. Conclusion: According to our data, the 675-nm laser source system seems to be safe and effective even in the treatment of facial melasma in patients with Fitzpatrick phototypes IV to V. This system is promising in the treatment of pigmentary diseases, thanks to its low interaction with water and vascular component, its high affinity with melanin, and its great ability to penetrate into the tissues with the reduction of heating. For color skin, cooling is very important as it protects the epidermis and reduces the risk of edema and erythema, which may lead to further postinflammatory hyperpigmentation.