Home About us Contact
|
Home About us Contact | ||
|
|
||
Melasma Area (melasma + area)
Selected AbstractsLow-Fluence Q-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser for Melasma with Pre- or Post-Treatment Triple Combination CreamDERMATOLOGIC SURGERY, Issue 6 2010SE-YEONG JEONG MD BACKGROUND Topical triple combination (TC) treatment is considered the primary approach to melasma. Recently, collimated low-fluence 1,064-nm Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser treatment has attracted attention as an alternative approach. OBJECTIVES To compare the clinical efficacy and adverse effects of low-fluence Q-switched Nd:YAG laser when performed before and after treatment with topical TC using a split-face crossover design. METHODS Thirteen patients with melasma received topical treatment with TC cream or 1,064-nm Q-switched Nd:YAG laser treatment on opposite sides of the face for 8 weeks, and then treatments were reversed for 8 weeks. Responses were evaluated using the Melasma Area and Severity Index scoring system, spectrophotometry measurements, and a subjective self-assessment method. RESULTS After 16 weeks, better results were seen in subjective assessments when laser treatment was used after 8 weeks of topical TC treatment than before usage of TC. There were no significant adverse effects with the laser treatments. CONCLUSIONS Laser treatment after topical TC cream was found to be safer and more effective than the post-treatment use of topical agents. The authors have indicated no significant interest with commercial supporters. [source] Treatment of Melasma Using Variable Square Pulse Er: YAG Laser ResurfacingDERMATOLOGIC SURGERY, Issue 3 2009RUNGSIMA WANITPHAKDEEDECHA MD BACKGROUND Treatment of melasma remains a challenge. Laser treatments show limited efficacy, with a high rate of recurrence and side effects. Recently, variable-pulsed erbium:yttrium aluminum garnet (Er:YAG) lasers have shown favorable results in skin resurfacing, with minimal downtime and adverse effects. OBJECTIVE To determine the efficacy and side effects of variable square pulsed (VSP) Er:YAG laser resurfacing for treatment of epidermal type melasma. METHODS Twenty Thai women with epidermal-type melasma were treated with two passes of VSP Er:YAG laser resurfacing using a 7-mm spot size, pulse duration of 300 ,s, and a fluence of 0.4 J/cm2. Two treatments were given 1 month apart. Visual analog scale (VAS), Melasma Area and Severity Index (MASI) score and melanin index (MI) were measured at baseline and 1, 2, and 4 months after treatment. RESULTS There was a significant improvement in VAS from baseline at 1-, 2-, and 4-month follow-up visits (p<.001). Significant improvement in MASI score at the 2-month visit from baseline (p=.004) was also observed. The average MI measured using melanin reflectance spectrometry measurements corresponded to MASI score rating. CONCLUSIONS VSP Er:YAG laser resurfacing effectively but temporarily improved epidermal-type melasma. Recurrence was observed after the treatment was discontinued. [source] Tretinoin Peels versus Glycolic Acid Peels in the Treatment of Melasma in Dark-Skinned PatientsDERMATOLOGIC SURGERY, Issue 5 2004Niti Khunger MD Background. Chemical peels have become a popular method for treating melasma. Although daily topical 0.05 and 0.1% tretinoin have been used for melasma, the therapy takes at least 4 to 6 months to produce clinically significant lightening. In a recent trial, 1% tretinoin peel has shown good clinical and histologic results after biweekly applications in 2.5 weeks only in the treatment of melasma. Objective. Because there is a paucity of studies evaluating the efficacy and safety of 1% tretinoin peel in the treatment of melasma in dark-skinned Asian population, we conducted a pilot study to evaluate the efficacy and side effects of this potentially new peeling agent versus a standard peeling agent, 70% glycolic acid, in the treatment of melasma in Indian women. Methods. Ten female patients of melasma, after written consent, were taken up for an open left,right comparison pilot study of 12 weeks. One percent tretinoin peel was applied on one-half of the face, whereas 70% glycolic acid was applied on the other at weekly intervals. The results were evaluated by a clinical investigator by using the modified Melasma Area and Severity Index and with photographs at baseline and 6 and 12 weeks. Results. A significant decrease in the modified Melasma Area and Severity Index from baseline to 6 weeks and then from 6 to 12 weeks was observed on both facial sides (p<0.001). Nevertheless, there was no statistically significant difference between the right and the left sides. Side effects were minimal and 1% tretinoin peel appeared to be well tolerated by the patients. Conclusions. It was concluded from the present trial that serial 1% tretinoin peel is a well tolerated and as effective a therapy for melasma in dark-skinned individuals as a standard and well-tried chemical peel, 70% glycolic acid, although larger trials over longer periods may be necessary to substantiate such findings. [source] Combined Ultrapulse CO2 Laser and Q-Switched Alexandrite Laser Compared with Q-Switched Alexandrite Laser Alone for Refractory Melasma: Split-Face DesignDERMATOLOGIC SURGERY, Issue 1 2003Suhattaya Angsuwarangsee MD Background. Melasma is common and can cause major psychological impact. To date, the mainstay of treatment, including various hypopigmenting agents and chemical peels, is ineffective and can cause adverse effects. Laser is a new approach and is yet to be explored for its efficacy and safety. Objective. To compare combined Ultrapulse CO2 laser and Q-switched alexandrite laser (QSAL) with QSAL alone in the treatment of refractory melasma. Methods. Six Thai females were treated with combined Ultrapulse CO2 laser and QSAL on one side of the face and QSAL alone on the other side. The outcome was evaluated periodically for up to 6 months using the modified Melasma Area and Severity Index score and the modified Melasma Area and Melanin Index score. Results. The side with combination treatment had a statistically significant reduction of both scores. On the QSAL side, the score reduction was not significant. Two cases developed severe postinflammatory hyperpigmentation and were effectively treated with bleaching agents. Transient hypopigmentation and contact dermatitis were observed with the combination treatment side. Conclusions. Combined Ultrapulse CO2 laser and QSAL showed a better result than QSAL alone but was associated with more frequent adverse effects. Long-term follow-up and a larger number of cases are required to determine its efficacy and safety for refractory melasma. [source] Aggravating factors for melasma: a prospective study in 197 Tunisian patientsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 9 2010C Guinot Abstract Background, Melasma is a frequent cause of consultations at dermatology departments by dark-skinned patients in Tunisia. Objective, To investigate factors that influence melasma severity in a large Tunisian population. Methods, A total of 197 patients (188 women and 9 men), who attended Tunis Military Hospital for a consultation were included prospectively from August 2005 to August 2006. Disease severity was estimated using the Melasma Area and Severity Index (MASI). Aggravating factors were investigated using multiple logistic regressions. Results, Of the women included, 14% presented phototype III, 45% phototype IV and 41% phototype V; 76% presented a centrofacial melasma phenotype, 23% a malar and 1% a mandibular phenotype. About 60% developed melasma before thirty. Sun exposure was reported as a triggering factor by 51% of women and as an aggravating factor by 84%. Pregnancy was reported as an aggravating factor by 51% of women who had been pregnant, and oral contraceptive use reported by 38% of women exposed to oral contraceptives. The risk of severe melasma was about three times higher for women with age at onset under 30, phototype V and major lifetime sun exposure and about 8 times higher for women exposed to oral contraceptives. Conclusion, This study identifies a number of factors associated with the severity of melasma. Further epidemiological studies in this type of population, in particular, to investigate triggering factors, are justified by the aesthetic damage caused by melasma in dark-skinned patients, lack of efficacy of existing treatments, non-compliance with photoprotection recommendations and the challenge of treatment. [source] Effect of melasma on quality of life in a sample of women living in southern BrazilJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 6 2008FM Freitag Abstract Background Melasma can cause a significant effect on individual emotional well-being. Melasma Quality of Life Scale (MELASQoL) is a specific questionnaire elaborated to assess the burden of melasma on patient's quality of life. Objective To evaluate the clinical aspects, severity and the influence of melasma on daily living of a sample of Brazilian women. Methods Cross-sectional study that enrolled 85 women with melasma older than 15 years of age. Trained investigators asked 55 questions to collect epidemiological and clinical data. The disease severity was clinically assessed using Melasma Area and Severity Index (MASI). Patients answered the Portuguese version of 10-item MELASQoL scale without coaching. Results The mean ± SD age was 41.1 ± 6.8 years, and the mean ± SD of MELASQoL score was 37.5 ± 15.2 (median, 35). Patients with previous psychiatric diagnosis had significantly higher MELASQoL scores (mean, 42.8; SD, 13.6) than patients without this antecedent (mean, 35.4; SD, 15.4; P < 0.05). Patients with less than 8 years of school attendance also had significantly higher MELASQoL score (mean, 44; SD, 16.9) than more graduated ones (mean, 34.4; SD, 13.5; P < 0.05). The mean ± SD MASI was 10.6 ± 6.6 (median, 10.2). There was no correlation between MASI and MELASQoL. Conclusions This study confirms that MELASQoL-BP is easy to administer, adds important information about the impact of melasma on South American women's life and, finally, contributes to building evidence on the validity, reliability and cultural adaptation of the Portuguese language MELASQoL version. [source] A double-blind controlled study of a nonhydroquinone bleaching cream in the treatment of melasmaJOURNAL OF COSMETIC DERMATOLOGY, Issue 4 2005Jean Luc Levy Summary Background, Melasma is an acquired hypermelanosis predominantly affecting the face of women. It is often recalcitrant to treatment with hypopigmenting agents. Objective, To assess the efficacy of a nonhydroquinone cream (Amelan M®) vs. another (Mela-D®) as treatment for melasma. Methods, Twenty-two French women with bilateral epidermal and/or mixed melasma were enrolled in a split-faced prospective trial lasting 4 months during summer season weeks. Twelve patients applied once-daily Amelan M® to one side of the face with sun-protective factor 60 UVA sunscreen each morning and Mela-D® once-daily to the other side of the face. Pigmentation was measured objectively using a mexameter and the melasma area and severity index (MASI) were measured subjectively. Results, The mean decrease of pigmentation was statistically significant on the MASI with both cream and only with Amelan M with the mexameter. Some adverse side effects were observed. Conclusions, Amelan M® is really more effective than Mela D® cream on melasma. Even though some side effects were observed patients preferred the Amelan M-treated side. [source] | ||||||||||