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KMID : 1037020160050010007
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Medical Lasers; Engineering, Basic Research, and Clinical Application
2016 Volume.5 No. 1 p.7 ~ p.16
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Current and New Strategies for Managing Non-Responders to Laser Toning in the Treatment of Melasma
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Park Young-Woon
Yeo Un-Cheol
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Abstract
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Melasma is one of the most common forms of acquired hyperpigmentation in Asians. It is often intractable with a high rate of recurrence. Several years ago, the collimated low-fluence 1,064 nm Q-switched neodymium-doped yttrium aluminum garnet laser was introduced as the "laser toning" for the treatment of melasma. Laser toning has been established as an excellent treatment option for melasma with proven efficacy, and it has gained widespread usage. Compared to the early days of laser toning, recent laser toning treatment is associated with lower fluence, fewer passes, wider intervals between treatment sessions, and a minimal and milder tissue response. This recent approach can reduce the risk of mottled hypopigmentation, postinflammatory hyperpigmentation, rebound hyperpigmentation, and recurrence of melasma. However, there are a growing number of non-responders to the recent laser toning technique, which can be problematic for some doctors. Dermatologists should be aware of the various ways to manage non-responders. Moreover, they should also have an accurate understanding of the mechanisms and principles of these modalities to apply optimal treatment methods for each patient condition and melasma state. Further research and updates are necessary to improve the safety and efficacy of laser therapy for melasma.
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KEYWORD
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Laser toning, Melasma, Non-responders, Q-switched neodymium-doped yttrium aluminum garnet laser
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