Oral Tranexamic Acid Enhances the Efficacy of Low-Fluence 1064-Nm Quality-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser Treatment for Melasma in Koreans: A Randomized, Prospective Trial

Shin, Jung U; Park, Jihun; Oh, Sang Ho; Lee, Ju Hee

doi:10.1111/dsu.12060

Cited by 95 publications

(104 citation statements)

References 24 publications

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“…5,6,9,14,15 After application of such treatment, the ultrastructural features of epidermal melanocytes have been shown to comprise fewer dendrites.…”

Section: Discussionmentioning

confidence: 99%

“…6,9,11,14 Previously, histopathological analyses of patients with melasma, who demonstrated remarkable clinical improvement after successive treatment of low fluence 1,064-nm QS Nd:YAG laser, revealed significant decreases in the expression of melanogenesis-associated proteins, including tyrosinase-related proteins, α-melanocytic-stimulating hormone, stem cell factor, and nerve growth factor, after laser treatment. 15 However, Melan-A and SOX-10 expression was not affected by the laser treatment.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] While numerous studies respectively favor the use of various treatment modalities, including topical bleaching agents, chemical peelings, oral tranexamic acid, and several kinds of light or laser devices, the optimal treatment for melasma has not yet been determined and is still under investigation, especially for different skin ethnity. [5][6][7][8] Among the light-or laser-based therapies, use of 1,064-nm Q-switched (QS) Nd:YAG lasers with low fluence for subcellular selective photothermolysis of melanocytes has been effectively and safely applied in the treatment of melasma. 5,6,[9][10][11] However, not all patients with melasma achieve satisfactory clinical outcomes with this treatment, and adverse events, including posttreatment petechiae, punctate leukoderma, and rebound hyperpigmentation, commonly develop.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7][8] Among the light-or laser-based therapies, use of 1,064-nm Q-switched (QS) Nd:YAG lasers with low fluence for subcellular selective photothermolysis of melanocytes has been effectively and safely applied in the treatment of melasma. 5,6,[9][10][11] However, not all patients with melasma achieve satisfactory clinical outcomes with this treatment, and adverse events, including posttreatment petechiae, punctate leukoderma, and rebound hyperpigmentation, commonly develop. 12,13 In reference to laser settings, the QS quick pulse-topulse (Q-PTP) mode irradiates 1,064-nm Nd:YAG laser energy of split fluence and at dual-pulse intervals of 80-μsec.…”

Section: Introductionmentioning

confidence: 99%

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A Pilot Split-face Comparison of Q-switched (QS) Single Pulse versus QS Quick Pulse-to-pulse 1,064-nm Nd:YAG Laser Treatment in a Patient with Melasma

Cho

Kang²,

Goo³

2013

Medical Lasers

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Melasma is a common disorder that clinically presents as symmetric illdefined hyperpigmented macules and patches on the face. In the current split-face, evaluator-blinded study, we treated a female patient with eight sessions of 1,064-nm Nd:YAG laser treatment at one-week intervals. Utilizing the Q-switched (QS) quick pulse-to-pulse (Q-PTP) mode, in reference to the laser settings, 1,064-nm Nd:YAG laser energy can be irradiated at split fluences and at a dual-pulse interval of 80-μsec. On the right side of the face, 1,064-nm QS single pulse Nd:YAG laser treatment was administered with the settings of 1.6 J/cm 2 , a spot size of 7-mm, and 1200 shots. On the left side, 1,064-nm QS Q-PTP Nd:YAG laser treatment was administered with the settings of 1.6 J/cm 2 irradiated at dual pulses of 0.8 J/cm 2 at 80-μsec intervals, a spot size of 7-mm, and 1,200 shots. Results of objective clinical assessment showed better clinical outcomes with less treatment-associated pain with QS Q-PTP-treatment than with QS single-pulse-treatment. However, clinical outcomes were subjectively indistinguishable between QS single pulse-and QS Q-PTP-treatments. Transient or persistent post-treatment erythema and newly developed punctate leukoderma lesions were not reported for either side of the face. Pre-existing punctate leukoderma lesions became obscure, especially on the QS Q-PTP-treated side, with improvement of the melasma lesions. We suggest that the QS Q-PTP mode may be of use in treatment of melasma, particularly on the relatively thin skin of the periorbital regions and in pain-sensitive and erythema-prone patients.

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“…5,6,9,14,15 After application of such treatment, the ultrastructural features of epidermal melanocytes have been shown to comprise fewer dendrites.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Pilot Split-face Comparison of Q-switched (QS) Single Pulse versus QS Quick Pulse-to-pulse 1,064-nm Nd:YAG Laser Treatment in a Patient with Melasma

Cho

Kang²,

Goo³

2013

Medical Lasers

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show abstract

“…The combination of TA and laser toning has a wealth of clinical experience with many studies reporting its efficacy and safety. 30,31 Unlike other combinations, the two components can be used simultaneously without an increase in the risk of complications. Recent studies have reported that TA can decrease laser-induced melanogenesis.…”

Section: Combination Therapy With Laser Toning (Excepting Other Lasermentioning

confidence: 99%

Current and New Strategies for Managing Non-Responders to Laser Toning in the Treatment of Melasma

Park

Yeo²

2016

Medical Lasers

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Melasma is one of the most common forms of acquired hyperpigmentation in Asians. It is often intractable with a high rate of recurrence. Several years ago, the collimated low-fluence 1,064 nm Q-switched neodymiumdoped yttrium aluminum garnet laser was introduced as the "laser toning" for the treatment of melasma. Laser toning has been established as an excellent treatment option for melasma with proven efficacy, and it has gained widespread usage. Compared to the early days of laser toning, recent laser toning treatment is associated with lower fluence, fewer passes, wider intervals between treatment sessions, and a minimal and milder tissue response. This recent approach can reduce the risk of mottled hypopigmentation, postinflammatory hyperpigmentation, rebound hyperpigmentation, and recurrence of melasma. However, there are a growing number of non-responders to the recent laser toning technique, which can be problematic for some doctors. Dermatologists should be aware of the various ways to manage non-responders. Moreover, they should also have an accurate understanding of the mechanisms and principles of these modalities to apply optimal treatment methods for each patient condition and melasma state. Further research and updates are necessary to improve the safety and efficacy of laser therapy for melasma.

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Influence of the frequency of laser toning for melasma on occurrence of leukoderma and its early detection by ultraviolet imaging

Sugawara

Kou²,

Kou³

et al. 2015

Lasers Surg Med

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There was no significant difference in the incidence of leukoderma related to the frequency of laser toning. This study showed that there are two types of leukoderma associated with laser toning. UV imaging was effective for the early detection of type 1 leukoderma, which seems to be related to the cumulative laser energy delivered, but not for detecting type 2 leukoderma, which may be due to direct phototoxicity.

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Oral Tranexamic Acid Enhances the Efficacy of Low-Fluence 1064-Nm Quality-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser Treatment for Melasma in Koreans: A Randomized, Prospective Trial

Abstract: Oral TA may prove a safe and efficient treatment option for melasma in combination with low-fluence QSNY laser therapy.

Cited by 95 publications

References 24 publications

A Pilot Split-face Comparison of Q-switched (QS) Single Pulse versus QS Quick Pulse-to-pulse 1,064-nm Nd:YAG Laser Treatment in a Patient with Melasma

A Pilot Split-face Comparison of Q-switched (QS) Single Pulse versus QS Quick Pulse-to-pulse 1,064-nm Nd:YAG Laser Treatment in a Patient with Melasma

Current and New Strategies for Managing Non-Responders to Laser Toning in the Treatment of Melasma

Influence of the frequency of laser toning for melasma on occurrence of leukoderma and its early detection by ultraviolet imaging

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