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Objectives: Melasma is a very common acquired pigmentary disorder with a high prevalence in women especially in phototypes IV to VI.

Introduction: Its main predisposing factors are ultraviolet radiation, environmental agents, smoking and hormones. Being considered today as an inflammatory and chronic disease that significantly affects patients’ quality of life, diverse therapeutic strategies have been proposed based on pathophysiological mechanisms involved in its origin.

Materials / method: The main objective in melasma treatment is to achieve a reduction in production and transfer of melanin through diverse types of treatments such as topical depigmenting products, light sources, chemical peels and microneedling.

Results: In the last five years, the systemic approach to melasma with agents such as tranexamic acid has been included.

Conclusion: This lecture synthesizes the most recent scientific information obtained from a literature review of the main studies and publications found in scientific databases which were related to melasma, oral treatment with tranexamic acid, it´s safety and effectivene

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Objectives: Melasma is a common disorder charcterised by hyperpigmentation occuring at the sun exposed areas, mostly on the face with bilateral locations (forehead, chicks, chin, nose and upper lip). Pathogenesis is not fully understood but there are some important factors of melasma such as: genetic predispositions, hormonal factors and UV and visible light radiation. Vascular component and subclinical inflammation also plays an important role in that disorder.

Introduction: Treatment of melasma is a challenge and there are many therapies for that disorder starting from sun protection, topical treatments, chemical peels, laser and light therapy threw systemic therapy etc.

Materials / method: In this case we present the 1927 thuluim laser technology and 1064nm picosecond laser technology for melasma treatment. Our experiencies with these technologies shows that the treatment is safe and efficient. Subablative parameters of the thulium laser makes the treatment safe and generates the small inflammation.

Results: Subablative parameters of the thulium laser makes the treatment safe and generates the small inflammation. 1064nm picosecond laser treatments were performed by two handpieces (full beam and fractional). Due to extremely short pulse duration compared to nanosecond lasers, picosecond technology generates much higher peak power density. We can observe the photomechanical and photoacoustic effect in irradiated skin with minimal thermal damage in surrounding tissue. Even low fluence parameters effectively destroy melanin pigment, what was proved by histological examination.

Conclusion: Treatment of melasma by these both technologies the thulium 1927nm laser and picosecond 1064nm laser is effective, safe, with minimum risk of PIH and with no downtime.

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Objectives: Melasma is an acquired, chronic pigmentary disorder predominantly affecting women. It may significantly affect quality of life and self-esteem due to its disfiguring appearance. Multiple treatments for melasma are available, but we are yet to find the optimal result.

Introduction: The aim of this talk is to review of all available in treatments for melasma.

Materials / method: Various options like topical creams,chemical peels, oral preparations and various types of laser treatments were evaluated in the treatment of Melasma,to understand their result and long term effects.

Results: There were multiple treatment options giving satisfactory results but none gave any permanent solution.

Conclusion: Hydroquinone monotherapy and triple combination cream are the most effective and well-studied treatments for melasma, whereas chemical peels and lasers also gave good results with long term maintenance. Oral tranexamic acid may be a safe, systemic adjunctive treatment for melasma, but needs to studied more.

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请注明名称（个人，公司，学会等等）: Boston Sante, Inc

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Objectives: To show the pros and cons of microneedle RF approach for melasma based on our various types of several patients treated with microneedle RF at our facility.

Introduction: The number of microneedle RF devices in Japan is recently increasing as expected for skin rejuvenation.
It can be expected to have a wide variety of therapeutic effects, including improving melasma, redness, and shrinking pores by selectively using a single long pulse (CW: Continuous Wave) that causes thermal coagulation in all layers of the skin, and a multi-short pulse (PW: Pulsed Wave) that selectively causes thermal coagulation in the basement membrane and blood vessels.

Materials / method: Our facility introduced pulsed oscillation microneedle RF in 2019, and as of November 2023, we have experienced a total of 54,438 cases. Among them, several noteworthy cases have been extracted for this study.

Results: Details of several melasma cases based on our various clinical experiences, for example, melasma improved with microneedle RF alone, melasma improved with oral medication or Q-Switched Nd:Yag Laser Toning, and melasma worsened after microneedle RF, etc. However, there are some points that require caution when using the microneedle RF device during treatment.

Conclusion: Microneedle RF has a rejuvenation effect on the skin, helps with vascular disorders, and can be used safely with patients with melasma. Patients with melasma who are worried about enlarged pores or wrinkles can be treated simultaneously with a single device. However, it is important for physicians to be aware of the caution points of microneedle RF.

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Objectives: Discuss Hyperpigmentation Etiologies, Treatment, and Outcomes.

Introduction: Pigmentary issues are one of the most common reasons for a visit to a dermatologist. Understanding etiology and treatment options are key for effective treatment.

Conclusion: Discuss evidence based approach 1) understanding causes of hyperpigmentation
2) treatment protocol
3) discussion of options for patients and physicians

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