Q-switched Nd: YAG laser versus trichloroacetic acid peeling in the treatment of melasma among Egyptian patients.

Abstract

BACKGROUND:

Melasma is a common disorder of facial hyperpigmentation that is often resistant to treatment.

OBJECTIVE:

To evaluate the efficacy of trichloroacetic acid (TCA) peeling in comparison with double frequency Q-switched neodymium-doped:yttrium aluminum garnet (QS-Nd:YAG) laser in the treatment of melasma.

PATIENTS AND METHODS:

Sixty-five adult Egyptian female patients with melasma were enrolled in this study. Wood light was used for determination of the histological type of melasma. The patients were divided into 4 groups according to treatment modalities: peeling with different concentrations of TCA and double frequency QS-Nd:YAG laser. Trichloroacetic acid peeling was performed every 2 weeks up to 8 sessions, whereas laser treatment was performed every month up to 6 sessions. Melasma area and severity index (MASI) score was used before and after treatment for evaluation.

RESULTS:

Improvement percentage of MASI score was significantly higher among patients treated with TCA 25% (p < .001). Epidermal type of melasma was significantly improved compared with the dermal type (p = .0029). Q-switched neodymium-doped:yttrium aluminum garnet laser showed the highest incidence of postinflammatory hyperpigmentation (53.3%).

CONCLUSION:

Trichloroacetic acid peeling is effective in the treatment of melasma, TCA 25% was the most effective concentration. Q-switched neodymium-doped:yttrium aluminum garnet laser is not recommended in the treatment of melasma because it was associated with the highest incidence of complications.

• Authors: Alaa E A Moubasher, Eman M K Youssef, Doaa A E Abou-Taleb
• Journal: Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (Dermatol Surg) Vol. 40 Issue 8 Pg. 874-82 (Aug 2014) ISSN: 1524-4725 [Electronic] United States
• PMID: 25068546 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Keratolytic Agents
• Trichloroacetic Acid

Topics

• Adult
• Chemexfoliation (adverse effects)
• Dermatitis, Contact (etiology)
• Egypt
• Face
• Female
• Humans
• Keratolytic Agents (administration & dosage)
• Lasers, Solid-State (adverse effects, therapeutic use)
• Melanosis (pathology, therapy)
• Middle Aged
• Patient Satisfaction
• Severity of Illness Index
• Trichloroacetic Acid (administration & dosage, adverse effects)
• Young Adult