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KMID : 1037020120010010003
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Medical Lasers; Engineering, Basic Research, and Clinical Application
2012 Volume.1 No. 1 p.3 ~ p.10
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Topical Application of Whitening Agents after Erbium-doped Yttrium Aluminum Garnet Fractional Laser Treatment for Melasma in Asians: A Randomized Controlled Split-face Study
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Kim Jeong-Eun
Kim Jae-Kyung
Ko Joo-Yeon
Ro Young-Suck
Chang Sung-Eun
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Abstract
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Background and Objectives: Melasma is a common hyperpigmentation disorder, which can cause refractory cosmetic disfigurement. Although fractional photothermolysis (FP) is an approved treatment for melasma, due to high relapse rates, its clinical efficacy remains controversial, especially in Asians. FP may be more useful for laser-assisted drug delivery. The objective of this study was to assess the efficacy of 2,940 nm erbium-doped yttrium aluminum garnet (Er-YAG) FP for melasma, and to compare laser treatment alone with that using laser-assisted topical whitening agents.
Materials and Methods: The faces of 12 Korean women with melasma were treated with six Er-YAG FP at 2 weeks intervals. One cheek was randomly selected for treatment with topical whitening agent after each laser treatment. The other cheek received treatment with vehicle solution. The modified melasma area severity index (MASI) and subjective physician/patient overall improvement assessments were used for measurement of outcome. These measures were recorded every two weeks during the treatment period and four weeks after the last treatment.
Results: Er-YAG FP induced clinical improvement after the third or fourth treatment, however, there was a tendency to rebound as the treatment continued. Application of a topical whitening agent after FP yielded significantly better MASI darkness, physician global assessment, and patient self assessment values than laser treatment alone.
Conclusion: Use of the Er-YAG FP laser initially resulted in improvement of melasma lesions; however, this effect was not sustained. Combination treatment comprising FP followed by application of topical whitening agent may be useful as an adjuvant option for treatment of melasma in Asian subjects, as FP may facilitate the penetration of topical drugs.
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KEYWORD
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Asian, Melasma, Fractional photothermolysis, Topical drugs
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