Treatment of refractory dermal melasma with the MedLite C6 Q-switched Nd:YAG laser: two case reports.
ABSTRACT Dermal melasma in Fitzpatrick skin types III-V usually does not respond to topical treatments. Laser resurfacing often either fails to treat these lesions or results in severe postinflammatory hyperpigmentation (PIH) or permanent hypopigmentation. Two cases of refractory dermal melasma are reported, which responded to treatment with the MedLite C6 Q-switched Nd:YAG laser.
Case 1: A 50-year-old Asian female with refractory dermal melasma and severe PIH received 10 weekly laser treatments combined with 7% alpha arbutin and a broad-spectrum sunscreen. Case 2: A 45-year-old Asian female with refractory dermal melasma received 10 weekly laser treatments combined with 7% alpha arbutin and a broad-spectrum sunscreen.
In both cases, there was a greater than 80% reduction in epidermal and dermal hyperpigmentation. The melanin index at the site of the lesions decreased from 50 to 35 and 45 to 33, respectively. There was no recurrence of melasma at 1 year (case 1) or 6 months (case 2).
Even in cases of long-standing refractory dermal melasma in a darker skin type, combination therapy has been shown to be an effective treatment for this difficult condition.
Conference Paper: Trapping And Cooling Of Atoms In Biue-detuned Doughnut-mode IightfieldsQuantum Electronics and Laser Science Conference, 1997. QELS '97., Summaries of Papers Presented at the; 06/1997
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ABSTRACT: The demographics of the US population continue to change at an extremely rapid pace. As of 2008, Asians, Hispanics, and African Americans accounted for 31% of the US population, and it is estimated that by the year 2050 half of the population of America will be represented by darker ethnic skin types. With the increase in the total number of individuals of skin of color, the demand for safe and effective laser therapy in darker skin types continues to increase. However, despite the increase in demand, the current literature regarding the use of lasers in darker skin remains limited. Most of the treatment parameters defined for laser platforms have been established primarily through extensive testing on skin phototypes I to III, and those studies that have been conducted on darker skin phototypes have been overwhelmingly conducted on Asian skin. Nevertheless, it has become clear that effective cutaneous laser surgery in darker skin types can be accomplished despite a relative overall greater risk for complications. Therefore, as the diversity of America continues to grow, the laser surgeon needs to maintain a clear understanding of the complexities associated with treating ethnic skin and remain mindful of the current, and ever-changing, therapeutic modalities available. This will allow the conscientious physician to maximize outcome and minimize risk when performing laser surgery on darker skin types.Seminars in cutaneous medicine and surgery 07/2009; 28(2):130-40. DOI:10.1016/j.sder.2009.04.003 · 2.40 Impact Factor