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Split-face study of melasma patients treated with non-ablative fractionated photothermolysis (1540 nm)


Barysch, M J; Rümmelein, B; Kolm, I; Karpova, M B; Schönewolf, N; Bogdan Allemann, I; Dummer, R (2012). Split-face study of melasma patients treated with non-ablative fractionated photothermolysis (1540 nm). Journal of the European Academy of Dermatology and Venereology, 26(4):423-430.

Abstract

Background  Melasma treatment remains challenging despite various laser systems available, because of potential side-effects and high recurrence rates. Objective  Non-ablative fractionated photothermolysis (FP) is a promising therapeutic method, long-time results comparing treated vs. non-treated site are lacking. Methods  A total of 14 patients were treated with FP in a split-face mode with standardized adjustments in three sessions (weeks 0, 3-4, 6-8, follow-up: 26-28). At each consultation, improvement was evaluated by patients and physicians. Objective assessment was performed using digital photographs and the pigment imaging tool SIAscope(®). Results  Melasma improvement was registered in 83% and 75% of the cases 26-28 weeks after the first treatment based on two evaluations: by patient and by physician, respectively. Digital photography and SIAscope(®) revealed improvement in 54% and 85% after the first, 61% and 85% after the second, 41% and 58% after the third treatment, accordingly, mostly due to reduction of the outline sharpness. Patients with lighter skin complexions revealed significant improvement ranged from slight to moderate (P = 0.03). Postinflammatory hyperpigmentation occurred in two cases with skin types III and IV. Conclusion  Non-ablative FP can be considered as a valuable treatment option with short-term improvement in terms of mild reduction and softening the edges of melasma in patients with skin types I/II, if prior topical therapies failed. Treatment of patients with skin types III+ should be critically questioned.

Background  Melasma treatment remains challenging despite various laser systems available, because of potential side-effects and high recurrence rates. Objective  Non-ablative fractionated photothermolysis (FP) is a promising therapeutic method, long-time results comparing treated vs. non-treated site are lacking. Methods  A total of 14 patients were treated with FP in a split-face mode with standardized adjustments in three sessions (weeks 0, 3-4, 6-8, follow-up: 26-28). At each consultation, improvement was evaluated by patients and physicians. Objective assessment was performed using digital photographs and the pigment imaging tool SIAscope(®). Results  Melasma improvement was registered in 83% and 75% of the cases 26-28 weeks after the first treatment based on two evaluations: by patient and by physician, respectively. Digital photography and SIAscope(®) revealed improvement in 54% and 85% after the first, 61% and 85% after the second, 41% and 58% after the third treatment, accordingly, mostly due to reduction of the outline sharpness. Patients with lighter skin complexions revealed significant improvement ranged from slight to moderate (P = 0.03). Postinflammatory hyperpigmentation occurred in two cases with skin types III and IV. Conclusion  Non-ablative FP can be considered as a valuable treatment option with short-term improvement in terms of mild reduction and softening the edges of melasma in patients with skin types I/II, if prior topical therapies failed. Treatment of patients with skin types III+ should be critically questioned.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2012
Deposited On:28 Jul 2011 11:11
Last Modified:05 Apr 2016 14:57
Publisher:Wiley-Blackwell
ISSN:0926-9959
Publisher DOI:10.1111/j.1468-3083.2011.04086.x
PubMed ID:21521377
Permanent URL: http://doi.org/10.5167/uzh-48834

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