摘要

Objectives: To assess the clinical effectiveness of the combination therapy of intense pulsed light (IPL) and microneedling with a postbiotic lotion containing Lactobacillus fermentation lysate in facial melasma, with the objective of developing a comprehensive and effective treatment strategy for melasma. Introduction: Intense pulsed light (IPL) alleviates skin pigmentation by the principle of selective photothermolysis. Lactobacillus fermentation lysate has the potential to repair the skin barrier and inhibit melanin production. Microneedling not only accelerates melanin metabolism and promotes skin self-repair but also enhances the transdermal absorption of therapeutic agents. However, the effectiveness and safety of the combination application of all three for melasma management remains to be fully elucidated. Materials / method: Thirty participants were randomly divided into two groups. The IPL therapy group received IPL treatment (wavelength: 590-640 nm, pulse width: 3.0-4.0 ms, pulse delay: 40-50 ms, energy density: 14-18 J/cm2) at four-week intervals over a consecutive period of twelve weeks. The combination therapy group participated in a regime where IPL therapy and microneedling (needle length: 0.5 mm) were alternately carried out every two weeks throughout the 12-week treatment duration. The postbiotic lotion was applied immediately after the microneedling procedure. Results: Compared to the baseline, both the IPL therapy group and the combination therapy group exhibited a significant reduction in the mMASI score, and the combination therapy group was more effective. The evidence of clinical photographic and VISIA-derived statistical data indicated that patients receiving the combined therapy experienced a decrease in facial speckle, a reduction in inflammation, and an improvement in hyperpigmentation, with over 73% of participants expressing very satisfied or satisfied. No significant adverse reactions were reported. Conclusion: Our study demonstrated that combination therapy yielded significantly greater efficacy than IPL monotherapy. This combined treatment exhibited multiple synergistic benefits, including inflammation reduction, accelerated melanin metabolism, the restoration of skin microecological equilibrium and skin barrier enhancement. These advancements promoted postoperative skin recovery and reduced the incidence of adverse effects, presenting a promising therapeutic approach for individuals diagnosed with melasma.