Combined Therapy Using Q-Switched Ruby Laser and Bleaching Treatment With Tretinoin and Hydroquinone for Acquired Dermal Melanocytosis

Abstract

QSR laser combined with the topical bleaching pretreatment appeared to treat ADM consistently with a low occurrence rate of PIH and lessen the number of laser sessions and total treatment period and may also be applied to any other lesions with both epidermal and dermal pigmentation.

Are Q-switched lasers for Nevus of Ota really effective in pigmented skin?

“…We read with interest the study of Kar et al, [1] but we would like to put in to perspective the optimistic outcome reported in view of the published data [2][3][4][5][6][7][8][9][10][11] [Table 1, Figure 1] and our findings [ Figure 2]. Our results with Q-switched Nd:YAG are not as heartening, as the majority of the patients have <25% response [ Figure 2].…”

Combined Therapy Using Q-Switched Ruby Laser and Bleaching Treatment with Tretinoin and Hydroquinone for Periorbital Skin Hyperpigmentation in Asians

“…Both epidermal and dermal pigmentation are present in acquired dermal melanocytosis. 5 The color of the periorbital region about which the patients complain appears to be very consistent among the patients, which is to say, grayish brown. Acquired dermal melanocytosis is also known as grayish brown dermatosis, and the similarity between the two morbidities is well demonstrated by histologic findings.…”

Treatment of Pigmented Lesions in the Asian Skin

“…One of the reasons for this is the higher rate of PIH seen after laser treatments for Hori's nevus. 80,86 The incidence of PIH ranged from 7-73% of cases and was transient, fading in 2-6 months with 4% hydroquinone cream. 81,84 The high rate of PIH may be related to the greater clustering of melanocytes around the blood vessels, as indirect vessel injury from the laser treatment leads to a higher degree of erythema and subsequently PIH.…”

“…The use of topical bleaching agents like hydroquinone and tretinoin to discharge epidermal melanin 4-6 weeks prior to Q-switched ruby laser was effective in Hori's nevus with a low rate of PIH and decreased the number of laser sessions. 3,86 Other combination treatments include the use of the scanned CO 2 laser to remove the epidermis followed by the Q-switched ruby laser has been shown to be more effective than Q-switched ruby laser alone in the treatment of Hori's nevus. 87 Ee et al showed that the combination of Q-switched 532 nm Nd:YAG laser (to remove epidermal hyperpigmentation) followed by the Q-switched 1064 nm Nd:YAG (532 nm, 4 mm spot, 1.2 J/cm 2 ; and 1064 nm, 4 mm spot, 6.5 J/cm 2 ) was more effective than Q-switched 1064 nm Nd:YAG laser alone for Hori's nevus.…”