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Ismail ESA, Patsatsi A, Abd El-Maged WM, Nada EEDAEA. Efficacy of microneedling with topical vitamin C in the treatment of melasma. J Cosmet Dermatol 2019; 18:1342-1347. [PMID: 30770637 DOI: 10.1111/jocd.12878] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 12/01/2018] [Accepted: 01/03/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Despite the wide therapeutic options available for the treatment of melasma, including many active topical medications, technologies with lights and peelings, clinical control of this disorder is extremely challenging. OBJECTIVES To evaluate the effect of microneedling with topical vitamin C in the treatment of melasma. METHODS Thirty female patients with melasma received six sessions of microneedling with addition of topical vitamin C every two weeks. At each session, photos were taken and Melasma Area and Severity Index (MASI) score was calculated to assess the clinical improvement. RESULTS Mean age of the eligible patients was 33.2 ± 5.77 years. About 50% of cases were of Fitzpatrick skin type III. All patients showed improvement at the end of the sessions. Mean MASI score in the first session was 8.61 ± 4.45 and there was a gradual decline in its value till it reached a mean of 5.75 ± 4.16 in the last session (P < 0.0001). CONCLUSION Microneedling with topical vitamin C is an effective and safe treatment option for epidermal melasma especially in Fitzpatrick skin phototypes I-III.
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Affiliation(s)
- Esraa Salah Ali Ismail
- Faculty of Medicine, Department of Dermatology, Sohag University, Sohag University Hospital, Sohag, Egypt
| | - Aikaterini Patsatsi
- Faculty of Medicine, 2nd Department of Dermatology, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
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LaRosa C, Chiaravalloti A, Jinna S, Berger W, Finch J. Laser treatment of medical skin disease in women. Int J Womens Dermatol 2017; 3:131-139. [PMID: 28831422 PMCID: PMC5555278 DOI: 10.1016/j.ijwd.2017.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 05/09/2017] [Accepted: 05/09/2017] [Indexed: 01/01/2023] Open
Abstract
Laser treatment is a relatively new and increasingly popular modality for the treatment of many dermatologic conditions. A number of conditions that predominantly occur in women and that have a paucity of effective treatments include rosacea, connective tissue disease, melasma, nevus of Ota, lichen sclerosus (LS), notalgia paresthetica and macular amyloidosis, and syringomas. Laser therapy is an important option for the treatment of patients with these conditions. This article will review the body of literature that exists for the laser treatment of women with these medical conditions.
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Affiliation(s)
- C. LaRosa
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT
| | - A. Chiaravalloti
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT
| | - S. Jinna
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT
| | - W. Berger
- Frank H. Netter MD School of Medicine, Quinnipiac University, North, Haven, CT
| | - J. Finch
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT
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Wat H, Wu DC, Chan HHL. Fractional resurfacing in the Asian patient: Current state of the art. Lasers Surg Med 2016; 49:45-59. [PMID: 27605303 DOI: 10.1002/lsm.22579] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVE Fractionated photothermolysis (FP) has revolutionized modern laser technology. By creating selective columns of microthermal damage, fractionated devices allows for greater treatment depths to be achieved without the prolonged downtime and risk of complications seen in traditional fully ablative laser resurfacing. Fractional resurfacing is a proven method to treat a variety of cutaneous conditions. In the Caucasian patient, a wide range of devices and treatment settings can be utilized safely and effectively. However, ethnic skin requires special consideration due to its unique pigmentary characteristics and clinical presentations. In this review article, we detail the current indications and strategies to optimize results and mitigate complications when utilizing fractional resurfacing for the Asian patient. METHODS A review of the MEDLINE English literature was conducted on fractionated laser devices studied in the Asian population. Articles included describe non-ablative devices including fractionated erbium glass, thulium fiber, diode, and radiofrequency devices; and ablative devices including fractionated carbon dioxide (CO2 ) laser, erbium yttrium aluminum garnet and yttrium scandium gallium garnet (YSGG) laser. These data were integrated with the expert opinion of the authors. CONCLUSION Taking into account the unique characteristics and cosmetic concerns of the Asian population, fractional resurfacing can be considered a safe and effective option for the treatment of atrophic and hypertrophic scarring, and photorejuvenation in ethnic skin types. Select cases of melasma may be treated with fractionated non-ablative devices, but utilized with caution. The predominant complication associated with fractional resurfacing for these conditions is post-inflammatory hyperpigmentation (PIH) and rebound worsening of melasma. A greater number of treatments at lower density settings and wider treatment intervals typically produce the lowest risks of PIH without compromising treatment efficacy. Lasers Surg. Med. 49:45-59, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Heidi Wat
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada, T6G 2G3
| | - Douglas C Wu
- Goldman, Butterwick, Groff, Fabi, and Wu Cosmetic Laser Dermatology, San Diego, California, 92121
| | - Henry Hin Lee Chan
- Division of Dermatology, Department of Medicine, University of Hong Kong, Hong Kong, SAR, China.,Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Yue B, Yang Q, Xu J, Lu Z. Efficacy and safety of fractional Q-switched 1064-nm neodymium-doped yttrium aluminum garnet laser in the treatment of melasma in Chinese patients. Lasers Med Sci 2016; 31:1657-1663. [DOI: 10.1007/s10103-016-2034-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 07/13/2016] [Indexed: 10/21/2022]
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Abstract
Nonablative photothermolysis has become an established technique in laser dermatology. It is mainly used for restructuring dermal connective tissue in order to treat, for example, acne scars or solar elastosis. It is also applied to the treatment of melasma and other benign cutaneous pigment disorders. This article discusses various indications in light of published observations and with regard to practical considerations.
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Affiliation(s)
- K Degitz
- Dermatologische Gemeinschaftspraxis, Pasinger Bahnhofsplatz1, 81241, München, Deutschland.
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6
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Rodrigues M, Pandya AG. Melasma: clinical diagnosis and management options. Australas J Dermatol 2015; 56:151-63. [DOI: 10.1111/ajd.12290] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 11/19/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Michelle Rodrigues
- Department of Dermatology; St Vincent's Hospital; Melbourne Victoria
- Department of Dermatology; The Royal Children's Hospital; Melbourne
- The Skin and Cancer Foundation; Inc
| | - Amit G Pandya
- Department of Dermatology; University of Texas; Southwestern Medical Centre; Dallas Texas USA
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Vachiramon V, Sirithanabadeekul P, Sahawatwong S. Low-fluence Q-switched Nd: YAG 1064-nm laser and intense pulsed light for the treatment of melasma. J Eur Acad Dermatol Venereol 2014; 29:1339-46. [DOI: 10.1111/jdv.12854] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 06/17/2014] [Indexed: 12/12/2022]
Affiliation(s)
- V. Vachiramon
- Ramathibodi Laser Center; Division of Dermatology; Ramathibodi Hospital; Mahidol University; Bangkok Thailand
| | - P. Sirithanabadeekul
- Ramathibodi Laser Center; Division of Dermatology; Ramathibodi Hospital; Mahidol University; Bangkok Thailand
| | - S. Sahawatwong
- Ramathibodi Laser Center; Division of Dermatology; Ramathibodi Hospital; Mahidol University; Bangkok Thailand
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Molinar VE, Taylor SC, Pandya AG. What’s New in Objective Assessment and Treatment of Facial Hyperpigmentation? Dermatol Clin 2014; 32:123-35. [DOI: 10.1016/j.det.2013.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lee SM, Kim MS, Kim YJ, Won CH, Lee MW, Choi JH, Moon KC, Chang SE. Adverse events of non-ablative fractional laser photothermolysis: a retrospective study of 856 treatments in 362 patients. J DERMATOL TREAT 2013; 25:304-7. [DOI: 10.3109/09546634.2013.777151] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sang Min Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Pureen Skin Clinic,
Seoul, Korea
| | | | - Youn Jin Kim
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Pureen Skin Clinic,
Seoul, Korea
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Pureen Skin Clinic,
Seoul, Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Pureen Skin Clinic,
Seoul, Korea
| | - Jee Ho Choi
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Pureen Skin Clinic,
Seoul, Korea
| | - Kee Chan Moon
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Pureen Skin Clinic,
Seoul, Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Pureen Skin Clinic,
Seoul, Korea
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Melasma and laser treatment: an evidenced-based analysis. Lasers Med Sci 2013; 29:589-98. [DOI: 10.1007/s10103-013-1318-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 04/08/2013] [Indexed: 11/25/2022]
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Lee HM, Haw S, Kim JK, Chang SE, Lee MW. Split-Face Study Using a 1,927-nm Thulium Fiber Fractional Laser to Treat Photoaging and Melasma in Asian Skin. Dermatol Surg 2013; 39:879-88. [DOI: 10.1111/dsu.12176] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Kim HS, Kim EK, Jung KE, Park YM, Kim HO, Lee JY. A split-face comparison of low-fluence Q-switched Nd: YAG laser plus 1550 nm fractional photothermolysis vs. Q-switched Nd: YAG monotherapy for facial melasma in Asian skin. J COSMET LASER THER 2013; 15:143-9. [DOI: 10.3109/14764172.2013.769274] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Beasley K, Dai JM, Brown P, Lenz B, Hivnor CM. Ablative Fractional Versus Nonablative Fractional Lasers—Where Are We and How Do We Compare Differing Products? CURRENT DERMATOLOGY REPORTS 2013. [DOI: 10.1007/s13671-013-0043-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Lasers are a very effective approach for treating many hyperpigmented lesions. They are the gold standard treatment for actinic lentigos and dermal hypermelanocytosis, such as Ota nevus. Becker nevus, hyperpigmented mosaicisms, and lentigines can also be successfully treated with lasers, but they could be less effective and relapses can be observed. However, lasers cannot be proposed for all types of hyperpigmentation. Thus, freckles and café-au-lait macules should not be treated as the relapses are nearly constant. Due to its complex pathophysiology, melasma has a special place in hyperpigmented dermatoses. Q-switched lasers (using standard parameters or low fluency) should not be used because of consistent relapses and the high risk of post-inflammatory hyperpigmentation. Paradoxically, targeting the vascular component of the melasma lesion with lasers could have a beneficial effect. However, these results have yet to be confirmed. In all cases, a precise diagnosis of the type of hyperpigmentation is mandatory before any laser treatment, and the limits and the potential side effects of the treatment must be clearly explained to patients.
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Affiliation(s)
- T Passeron
- Department of Dermatology, INSERM U1065, Nice CHU, France.
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16
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Ho SGY, Yeung CK, Chan NPY, Shek SY, Chan HHL. A retrospective study of the management of Chinese melasma patients using a 1927 nm fractional thulium fiber laser. J COSMET LASER THER 2013; 15:200-6. [DOI: 10.3109/14764172.2012.761346] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Stephanie G Y Ho
- Division of Dermatology, Department of Medicine, The University of Hong Kong, Hong Kong SAR, China.
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Niwa Massaki ABM, Eimpunth S, Fabi SG, Guiha I, Groff W, Fitzpatrick R. Treatment of melasma with the 1,927-nm fractional thulium fiber laser: A retrospective analysis of 20 cases with long-term follow-up. Lasers Surg Med 2012; 45:95-101. [DOI: 10.1002/lsm.22100] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2012] [Indexed: 11/05/2022]
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Abstract
Melasma is an acquired hypermelanosis that results in localized hyperpigmentation, commonly found on the face. This condition is much more common in women than men. There are some features of melasma in men that seem to differ from those seen in women. However, there is a paucity of data on this topic. The aim of this article is to review the etiology, clinical presentation, and treatment of melasma in men. It is important for dermatologists to understand some unique aspects of melasma in this group to provide appropriate care for patients who suffer from this frustrating condition.
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Affiliation(s)
- Vasanop Vachiramon
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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20
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Kauvar AN. The Evolution of Melasma Therapy: Targeting Melanosomes Using Low-Fluence Q-Switched Neodymium-Doped Yttrium Aluminium Garnet Lasers. ACTA ACUST UNITED AC 2012; 31:126-32. [DOI: 10.1016/j.sder.2012.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 02/17/2012] [Accepted: 02/17/2012] [Indexed: 10/28/2022]
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