Melasma is an acquired disorder of hyperpigmentation affecting millions of individuals worldwide. It is mostly observed in the facial area of darker-complexioned individuals (skin types IV-VI) exposed to intense ultraviolet (UV) radiation 1 and shorter wavelengths of visible light (VL). 2 At least 90% of those affected are women. 1 Melasma is characterized by symmetrically oriented hyperpigmented macules and patches, with varying presentations including blotchy, irregular, arcuate, and polycyclic. 3 One way of dividing the disorder into different subtypes is based on the distribution pattern: centrofacial (the most common), malar, and mandibular. Another division is

Background: Melasma is an acquired disorder of hyperpigmentation, affecting a million individuals worldwide. Energy-based devices (EBDs) employed to treat melasma include various types of lasers, intense pulsed light (IPL), and radiofrequency (RF).Recent studies have attempted to address recalcitrant and recurring melasma by combining energy-based devices with topical or oral medications.Objective: This article reviews EBDs-based augmented treatment for melasma and suggests practical pathogenesis-oriented treatment regimens. Treatment algorithms are proposed to address various components of melasma.Methods: A systematic PubMed search was conducted acquiring information from various studies on combination treatments of melasma involving EBDs. Results:The 286 retrieved articles were filtered by title to contain at least one type of energy-based modality such as laser, IPL, or RF along with at least one other treatment method. Based on their subject matter, combinations were further categorized into the subheadings: laser plus medication, laser plus laser, and IPL-and RF-containing treatment methods. Conclusion:There are many energy-based combination treatments that have been explored for mitigation of melasma including laser therapy with medication, multilaser therapies, IPL, RF, and microneedling devices. Melasma is an exceedingly difficult condition to treat, however, choosing the appropriate tailor-made treatment combination can improve the final outcome.

Hepatocellular carcinoma (HCC) treatment is variable and depends on the size, location, and presence of extra hepatic metastasis and vascular invasion. HCC treatment options have advanced significantly over the past few decades and include surgical and non-surgical methods. In the past, systemic chemotherapy was the non-surgical treatment and there was no significant increase in overall survival rate. Nowadays sorafenib, a molecular targeted drug, is the treatment of choice and has shown proven benefits in increasing survival time; other systemic therapies did not show longer statistical superiority. However, surgical treatments, such as liver transplantation and surgical resection, are still the only methods offering a curative opportunity; however, these are not free of adverse effects and recurrence of the tumour. Non-surgical techniques including ablative treatment, radiotherapy, transarterial chemoembolisation, and percutaneous ethanol injection also show some benefit in the survival of patients with HCC. Future molecular targeted drugs are currently under investigation in different stages of clinical trials, and there are positive expectations regarding their benefit in treating HCC.