Melasma treatment using an erbium:<scp>YAG</scp> laser: a clinical, immunohistochemical, and ultrastructural study

Attwa, Enayat; Khater, Mohamed Hamed; Assaf, Magda; Haleem, Manal Abdel

doi:10.1111/ijd.12477

Cited by 24 publications

(21 citation statements)

References 32 publications

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“…Therein, post‐Er:YAG skin specimens exhibited decreased melanocytes and melanosomes . However, postinflammatory hyperpigmentation and recurrent melasma lesions required further treatment . In our experience, light and laser sources must be cautiously delivered for treating melasma in Asian patients, and treatment with BBL at low fluence and a long pulse duration and with Er:YAG resurfacing at 1.0 and 1.5 J/cm 2 seems to prevent side effects.…”

Section: Discussionmentioning

confidence: 75%

“…However, therein, all of the patients developed postinflammatory hyperpigmentation, and the authors recommended Er:YAG laser treatment only for refractory melasma with persistent intervention . Meanwhile, another study demonstrated that Er:YAG laser resurfacing in 15 Egyptian female patients with melasma at 1.0 J, a spot size of 5 mm, and approximately 30% overlapping over 2 passes markedly improved mean melasma area and severity index score . Therein, post‐Er:YAG skin specimens exhibited decreased melanocytes and melanosomes .…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, another study demonstrated that Er:YAG laser resurfacing in 15 Egyptian female patients with melasma at 1.0 J, a spot size of 5 mm, and approximately 30% overlapping over 2 passes markedly improved mean melasma area and severity index score . Therein, post‐Er:YAG skin specimens exhibited decreased melanocytes and melanosomes . However, postinflammatory hyperpigmentation and recurrent melasma lesions required further treatment .…”

Section: Discussionmentioning

confidence: 99%

“…Low‐fluenced Er:YAG resurfacing elicits ablative photothermal tissue reactions confined to the uppermost epidermis, with markedly higher coverage percentages than fractional resurfacing . Therein, the structural integrity of the basement membrane is preserved by finely regulating the penetration depth of Er:YAG laser pulses .…”

Section: Introductionmentioning

confidence: 99%

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Low‐fluenced erbium:yttrium‐aluminium‐garnet laser treatment in combination with broadband light pretreatment for various pigmentation disorders in Asian patients

Kim

Park

Zheng

et al. 2019

J of Cosmetic Dermatology

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Summary Background Low‐fluenced 2940‐nm erbium (Er):yttrium‐aluminium‐garnet (YAG) resurfacing elicits ablative photothermal tissue reactions confined to the uppermost parts of the epidermis. Objective To demonstrate the efficacy and safety of low‐fluenced ablative Er:YAG laser treatment in combination with broadband light (BBL) pretreatment for various pigmentation disorders. Methods In total, 35 Korean patients with various pigmentation disorders were pretreated with BBL, and then, low‐fluenced Er:YAG laser resurfacing was performed with a beam size of 4 mm and a fluence of 1.0‐1.5 J/cm2. Results An average of 1.1 ± 0.4 sessions of combined BBL and low‐fluenced Er:YAG resurfacing treatment was delivered to the patients. Most post‐Er:YAG scaling fell off spontaneously over 3‐5 days, and most of the post‐BBL crusting disappeared spontaneously over 5‐7 days. At 2 months after final treatment, the mean global aesthetic improvement scale score for the clinical improvement of pigmentation lesions was estimated as 2.5 ± 0.8, and that for the improvement of overall skin tone, texture, and wrinkles was 2.8 ± 1.0. Conclusion Our data demonstrated that post‐BBL, low‐fluenced Er:YAG laser resurfacing can be used to effectively treat various pigmentation disorders in Asian patients. Further improvements in overall skin tone, texture, and wrinkles were also achieved without major side effects.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Low‐fluenced erbium:yttrium‐aluminium‐garnet laser treatment in combination with broadband light pretreatment for various pigmentation disorders in Asian patients

Kim

Park

Zheng

et al. 2019

J of Cosmetic Dermatology

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“…Recurrence of melasma was noticed in five patients and PIH was noticed three to six months after treatment began. The study found that 2940-nm Er:YAG ablative laser resurfacing effectively improved melasma; however, the PIH's transient appearance needs persistent and prompt intervention [25] . Manaloto et al reported improvement of melasma immediately after treatment with Er:YAG laser.…”

Section: Ablative Fractionated Lasersmentioning

confidence: 91%

Energy-based devices for treatment of melasma

Jordão

Rebellato

2017

J Surg Dermatol

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Melasma, as a pigmentation disorder, induces significant stress to the patients and its recurrent nature remains a challenge in clinical practice. Treatment is based on a variety of mechanisms to prevent and/or stop the pigment production process by destroying the deposited pigment for removal or release, by peeling cells to improve their turnover, and by reducing inflammation. The use of appropriate devices and correct settings are crucial in the treatment of melasma. Cases unresponsive to topical bleaches or chemical peels should be referred for laser therapy. It is important that a maintenance therapy to avoid the recurrence of melasma be indicated. In this paper, we review energy-based devices for melasma treatment.

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Energy‐based devices for melasma and postinflammatory hyperpigmentation

Reynal

Eisenacher

2023

Dermatological Reviews

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Introduction: Melasma and postinflammatory hyperpigmentation (PIH) are conditions commonly encountered by dermatologists, and they are often distressing to patients. While PIH can improve with time once the inflammatory process is controlled, melasma is a condition that often requires prolonged treatment and maintenance. There are numerous treatment options, ranging from UV protection and topical therapies (such as hydroquinone), to more procedural-based options (chemical peels, micro-needling, and energy-based devices).Objective: This review will focus on the treatment of melasma and PIH with various energy-based therapies, including laser devices, intense pulsed light (IPL), highfrequency ultrasound, and radiofrequency devices.Methods: References were collected by using Pubmed with search terms of "laser", "melasma", "post-inflammatory hyperpigmentation", and "energy-based devices."Findings: Lasers and IPL target pigment in the epidermis and dermis by using the appropriate wavelengths and principles such as thermal relaxation time and photoacoustic damage. Other lasers, such as pulsed-dye laser (PDL), target the vascular component of melasma. Used alone or in combination with topical treatments, these devices provide improvement in melasma and PIH. In addition, some authors have studied the use of these devices, such as fractionated lasers, in device-assisted drug delivery of topical therapies. Conclusion:While there is a benefit to the use of these devices, this change is usually temporary and balanced against the side effects of dyspigmentation and scarring. Therefore, these treatments are best used in combination, with a maintenance program that employs both topical therapies, procedures, and energy-based devices.

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Melasma treatment using an erbium:YAG laser: a clinical, immunohistochemical, and ultrastructural study

Abstract: Erbium:YAG laser resurfacing effectively improves melasma; however, the almost universal appearance of transient postinflammatory hyperpigmentation necessitates prompt and persistent intervention.

Cited by 24 publications

References 32 publications

Low‐fluenced erbium:yttrium‐aluminium‐garnet laser treatment in combination with broadband light pretreatment for various pigmentation disorders in Asian patients

Low‐fluenced erbium:yttrium‐aluminium‐garnet laser treatment in combination with broadband light pretreatment for various pigmentation disorders in Asian patients

Energy-based devices for treatment of melasma

Energy‐based devices for melasma and postinflammatory hyperpigmentation

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