Nonablative 1550-nm fractional laser therapy versus triple topical therapy for the treatment of melasma: a randomized controlled pilot study.

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.

• Authors: Marije W Kroon, Bas S Wind, Johan F Beek, J P Wietze van der Veen, Ludmila Nieuweboer-Krobotová, Jan D Bos, Albert Wolkerstorfer
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 64 Issue 3 Pg. 516-23 (Mar 2011) ISSN: 1097-6787 [Electronic] United States
• PMID: 21255869 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Chemical References

• Hydroquinones
• Tretinoin
• Triamcinolone Acetonide
• hydroquinone

Topics

• Administration, Topical
• Adult
• Female
• Humans
• Hydroquinones (therapeutic use)
• Laser Therapy (adverse effects, methods)
• Melanosis (drug therapy, therapy)
• Middle Aged
• Pilot Projects
• Recurrence
• Treatment Outcome
• Tretinoin (therapeutic use)
• Triamcinolone Acetonide (therapeutic use)