Nonablative 1550-nm fractional laser therapy versus triple topical therapy for the treatment of melasma: A randomized controlled pilot study - 10/08/11
, Bas S. Wind, MD a, b, Johan F. Beek, MD, PhD a, b, c, J.P. Wietze van der Veen, MD, PhD a, b, d, Ludmila Nieuweboer-Krobotová, MD a, b, d, Jan D. Bos, MD, PhD, FRCP b, Albert Wolkerstorfer, MD, PhD a, b
Reprint requests: Marije W. Kroon, MD, Netherlands Institute for Pigment Disorders, Meibergdreef 35, 1105 AZ Amsterdam, The Netherlands.Abstract |
Background |
Various treatments are currently available for melasma. However, results are often disappointing.
Objective |
We sought to assess the efficacy and safety of nonablative 1550-nm fractional laser therapy and compare results with those obtained with triple topical therapy (the gold standard).
Methods |
Twenty female patients with moderate to severe melasma and Fitzpatrick skin types II to V were treated either with nonablative fractional laser therapy or triple topical therapy (hydroquinone 5%, tretinoin 0.05%, and triamcinolone acetonide 0.1% cream) once daily for 8 weeks in a randomized controlled observer-blinded study. Laser treatment was performed every 2 weeks for a total of 4 times. Physician Global Assessment was assessed at 3 weeks, 3 months, and 6 months after the last treatment.
Results |
Physician Global Assessment improved (P < .001) in both groups at 3 weeks. There was no difference in Physician Global Assessment between the two groups. Mean treatment satisfaction and recommendation were significantly higher in the laser group at 3 weeks (P < .05). However, melasma recurred in 5 patients in both groups after 6 months. Side effects in the laser group were erythema, burning sensation, facial edema, and pain; in the triple group side effects were erythema, burning, and scaling.
Limitations |
Limitations were: small number of patients; only one set of laser parameters; and a possible difference in motivation between groups.
Conclusions |
Nonablative fractional laser therapy is safe and comparable in efficacy and recurrence rate with triple topical therapy. It may be a useful alternative treatment option for melasma when topical bleaching is ineffective or not tolerated. Different laser settings and long-term maintenance treatment should be tested in future studies.
Le texte complet de cet article est disponible en PDF.Key words : bleaching, melasma, nonablative fractional laser therapy, randomized, triple topical therapy
Abbreviations used : MASI, PGA, PhGA
Plan
| The first two authors contributed equally to this article. |
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| Funding sources: None. |
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| Conflicts of interest: None declared. |
Vol 64 - N° 3
P. 516-523 - mars 2011 Retour au numéro
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