The vascular characteristics of melasma

Kim, En Hyung; Kim, You Chan; Lee, Eun‐So; Kang, Hee Young

doi:10.1016/j.jdermsci.2007.01.009

Cited by 282 publications

(288 citation statements)

References 14 publications

(13 reference statements)

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“…This phenomenon is called the "skin effect". 17 This effect is beneficial to melasma treatment and preventing PIH. For example, for fine vessels in the reticular dermis, if the resistance of the reticular dermis is 400 mohm and the intravascular resistance is 0 mohm, alternating current will accumulate on the vascular surface, since vessels behave as conductors (Fig.…”

Section: Discussionmentioning

confidence: 99%

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Therapeutic Efficacy and Safety of Invasive Pulsed-Type Bipolar Alternating Current Radiofrequency on Melasma and Rebound Hyperpigmentation

Kim¹,

Lee²

2017

Medical Lasers

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Background and ObjectivesLaser treatment for melasma is typically associated with various complications, especially rebound hyperpigmentation (RH) and mottled hypopigmentation. The purpose of this case review was to analyze the clinical efficacy and safety of using an uinvasive pulsed-type bipolar alternating current radiofrequency (IBPRF) for treating melasma with or without RH. Materials and MethodsClinical improvement in the appearances of melasma and RH was analyzed in 142 Korean patients (4 men and 138 women, with a mean age of 37.3 ± 11 years), who had undergone IBPRF treatment for melasma. IBPRF was delivered at a frequency of 2 MHz and with non-insulated, penetrating microneedles over five to 10 treatment sessions at 2-to 3-week intervals. ResultsIn total, 124 patients had melasma, and among them,18 patients had melasma with RH. To treat melasma, IBPRF alone was administered to 112 subjects, IBPRF plus a Q-switched Q-switched neodymium-yttriumaluminum-garnet (Nd:YAG) laser in 22 patients, IBPRF plus intralesional tranexamic acid injection in five patients, and IBPRF plus bleaching cream in three patients. Patients reported subjective satisfaction with the appearance of their melasma lesions after seven to eight treatment sessions, regardless of whether they underwent treatment with pulsed RF alone or combination treatment. After treatment, no significant complications, particularly RH or mottled hypopigmentation, were recorded. ConclusionNo severe complications related to IBPRF treatment were recorded, and patients reported satisfaction in the appearance of their lesions after seven to eight treatment sessions. This suggests that IBPRF may be effective and safe for treating melasma and RH. Key words

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Section: Discussionmentioning

confidence: 99%

“…Thus, the selectivity of RF treatment for vessel diameter can be applied to melasma or vascular treatment to improve diffuse erythema after IBPRF treatment. 17 The dermal environment is also improved after RF treatment. We suggest that, first, RF accelerates washing out of dermal melanin, followed by stimulation of neocollagenesis.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Efficacy and Safety of Invasive Pulsed-Type Bipolar Alternating Current Radiofrequency on Melasma and Rebound Hyperpigmentation

Kim¹,

Lee²

2017

Medical Lasers

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“…Accumulating evidence has shown that the number of blood vessels is higher in melasma lesions than in perilesional normal skin [23][24][25]. An immunohistochemical study of factor VIIIa-related antigen showed a considerable increase in the number of enlarged blood vessels, vessel size, and vessel density in melasma skin compared with perilesional normal skin [23].…”

Section: Increased Vascularizationmentioning

confidence: 99%

“…An immunohistochemical study of factor VIIIa-related antigen showed a considerable increase in the number of enlarged blood vessels, vessel size, and vessel density in melasma skin compared with perilesional normal skin [23]. The elevated expression of vascular endothelial growth factor (VEGF) in keratinocytes has led to the hypothesis that VEGF may play a role in the behavior of the melanocytes in the skin, because functioning VEGF receptors were demonstrated in melanocytes in vitro [26].…”

Section: Increased Vascularizationmentioning

confidence: 99%

Clues to the Pathogenesis of Melasma from its Histologic Findings

Kwon¹

2014

Pigmentary Disorders

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“…Vascular endothelial growth factor (VEGF) is highly expressed in melasma lesions and the melanocytes VEGF receptors 1 and 2, which are involved in the pigmentation process [95][96][97][98]. PDL may decrease melanocyte stimulation and more importantly, decrease subsequent relapses [99].…”

Section: Pulsed Dye Laser (Pdl)mentioning

confidence: 99%

Melasma, Novel Treatment Modalities

Abdallah¹

2014

Pigmentary Disorders

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Treatment of melasma remains challenging due to frequent relapses and the occurrence of post-inflammatory hyperpigmentation (PIH) following many interventions. Treatment goals are inhibition of melanin synthesis and transfer by sunscreens, sun avoidance and the use of bleaching agents on one hand and removal of already present pigment by peeling, lasers and light on the other hand. Triple combination creams (TCC) (also known as Kligman's formula utilizing hydroquinone and modifications of Kligman's formula) remain the mainstay of treatment. Newer bleaching agents derived from plants and synthetic compounds have been introduced and many of them are promising safe substitutes for hydroquinone.Peeling agents especially superficial and medium depth peels are effective treatment modalities for melasma. Newer peeling agents are less irritating and may thus lead to fewer side effects. Q-switched lasers, which target melanin, have led to PIH until the innovation of "laser toning" and fractional Qswitched ruby, which have better outcomes. Fractional non-ablative and ablative lasers are useful at lower fluencies. Pulsed dye laser, which targets the vascular component in melasma, is promising with less melasma rebound.Combinations of the above-mentioned modalities usually have a better treatment outcome than either alone. This review will focus on the more recently introduced therapies.

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The vascular characteristics of melasma

Cited by 282 publications

References 14 publications

Therapeutic Efficacy and Safety of Invasive Pulsed-Type Bipolar Alternating Current Radiofrequency on Melasma and Rebound Hyperpigmentation

Therapeutic Efficacy and Safety of Invasive Pulsed-Type Bipolar Alternating Current Radiofrequency on Melasma and Rebound Hyperpigmentation

Clues to the Pathogenesis of Melasma from its Histologic Findings

Melasma, Novel Treatment Modalities

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