Post-inflammatory and rebound hyperpigmentation as a complication after treatment efficacy of telangiectatic melasma with 585 nanometers Q-switched Nd: YAG laser and 4% hydroquinone cream in Skin Phototype III-V
Parole chiave
Astratto
Background: The potential efficacy of vascular component-targeted laser has been evaluated for treatment of melasma, which commonly found with the co-existence of telangiectasia.
Objective: To evaluate the treatment efficacy and safety of 585-nm QSNYL and 4% HQ cream combination versus 4% HQ cream alone for telangiectatic melasma in the skin phototype III-V.
Methods: Twenty-one Thai female patients with telangiectatic melasma and Fitzpatrick skin phototype (FPT) III-V were randomly treated with the 585-nm QSNYL on one side of the face for five sessions at 2-week intervals. All patients were assigned to apply HQ cream daily at night on both sides of the face for ten weeks and a broad-spectrum sunscreen regularly throughout the study. The treatment efficacy and safety were evaluated using the Modified Melasma Area and Severity Index (mMASI), biometric evaluation, patient assessment, and adverse effects.
Results: The combination treated side yielded more significant improvement of mMASI than the topical treated side at week 2, 4, and 8, respectively. However, 19% of the patients developed post-inflammatory hyperpigmentation (PIH) on the laser treated side, especially in FPT IV-V and rebound hyperpigmentation. There was a significant improvement of hemoglobin and melanin index, but without statistical difference between the two treatment groups.
Conclusions: The combination of 585-nm QSNYL and HQ treatment yields treatment efficacy and skin rejuvenation effects for telangiectatic melasma. Nonetheless, a high incidence of PIH and rebound hyperpigmentation is adversely developed in dark FPT. Thus, this laser treatment should be cautiously applied in those with dark FPT IV-V to avoid laser-induced pigment alteration.
Keywords: 585nm Q-Switched Nd: YAG laser; Laser therapy; Post-inflammatory hyperpigmentation; Telangiectasia melasma.
