Treatment of Melasma Using a Novel 1,927 nm Fractional Thulium Laser: A Retrospective Analysis of 68 Korean Patients

Rho, Nark-Kyoung

doi:10.25289/ml.2017.6.1.10

Cited by 5 publications

(6 citation statements)

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“…To the authors' knowledge, to date, this study represents the largest prospective study using both subjective and objective endpoints to the efficacy of f1927 nm in improving the appearance of melasma and actinic pigment. 22,23,25,38 These results demonstrate that fractionated, nonablative 1927 nm laser treatment is an effective modality for improving both clinical and subclinical pigment in patients of Fitzpatrick SPT I-IV. The magnitude and duration of pigment improvement are potentially influenced by extrinsic factors such as increased exposure to and propensity for photodamage during the summer months, which may suggest the need for multiple f1927 nm treatments over time to maintain clinical results.…”

Section: Discussionmentioning

confidence: 82%

Investigating the efficacy of a fractionated 1927 nm laser for diffuse dyspigmentation and actinic changes

et al. 2023

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Objectives Facial actinic irregularities are frequent targets for noninvasive, energy‐based treatment. These irregularities are multifactorial and driven by both intrinsic factors such as aging, genetics, and hormone exposure, and extrinsic factors, such as UV exposure. Clinically, this photodamage manifests as dyschromic skin disorders like melasma and actinic features such as solar lentigines. Fractionated 1927 nm (f1927 nm) nonablative lasers are suitable for targeting epidermal lesions and have been shown to be effective in resurfacing photoaged skin as well as addressing pigmented lesions without exacerbation. The purpose of this study was to quantify the magnitude and duration of actinic pigment and photodamage response in patients of Fitzpatrick Skin Phototypes (SPT) I–IV who underwent two treatments with a fractionated, nonablative 1927 nm thulium laser (MOXI™, Sciton). Methods The authors conducted an IRB‐approved, single‐center, prospective, nonrandomized study to evaluate the efficacy of f1927 nm nonablative lasers in the treatment of diffuse dyspigmentation and actinic irregularities. Patients underwent two treatments with f1927 nm nonablative laser at a 1‐month interval. F1927 nm treatment and energy parameters included a pulse energy of 15 mJ, density of 15% with 15% coverage, and six total passes. The primary endpoint for this study was pigment response after treatment, measured using the VISIA Skin Imaging and Analysis System (Canfield Scientific). Pigmentary lesions measured and analyzed included spots, UV spots, and brown spots. The Physician's Global Assessment Scale was used by plastic surgeons to provide a subjective clinical assessment of melasma response. Nonparametric testing was used to assess and compare VISIA results across the study period as well as clinician evaluations. A p value ≤ 0.05 was considered statistically significant. Results Twenty‐seven patients underwent two treatments with nonablative, f1927 nm laser in May and June 2022. Ninety‐six percent of patients (n = 26) completed 1‐month follow‐up and 89% of patients (n = 24) completed 3‐month follow‐up. The study cohort was 100% female, with a mean ± SD age of 47.0 ± 11.5 (range: 29–74), and a mean Fitzpatrick SPT of 2.8 (range: I–IV). No serious adverse events were observed during study treatment or follow‐up. Overall, analysis showed statistically significant improvements in dyspigmentation at 1 month and an increase in pigment toward baseline at 3 months. At 1 month, there was a statistically significant decrease in spots (p = 0.002), UV spots (p < 0.001), and brown spots (p < 0.001) compared to baseline. At 3 months, Brown spots remained significantly improved compared to baseline (p = 0.05). Analysis showed 9.9% improvement in pigment on the left (p < 0.0001) and 7.5% improvement in pigment on the right (p < 0.0001) face. Right dyspigmentation remained significantly improved at 3‐month follow‐up (p = 0.02). Subjectively, clinician evaluators' mean Physician's Global Assessment Scale score was 3.4 (p < 0.0001) at ...

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Section: Discussionmentioning

confidence: 82%

Investigating the efficacy of a fractionated 1927 nm laser for diffuse dyspigmentation and actinic changes

et al. 2023

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“…The use of NAFLs seems to provide a more sustained clinical response than IPL or Q-switched laser treatments, especially when patients use topical tyrosinase inhibitor treatment before and after surgery. Numerous studies show the effectiveness of NAFLs [178,[222][223][224][225][226]; although, for all types of NAFL the recurrence of pigmented lesions occurs. The data suggest that relapse is observed between 3 and 6 months, while with IPL and Q-switched, it occurs as early as 3 months after stopping treatment [182].…”

Section: Laser Therapymentioning

confidence: 99%

Understanding Melasma-How Can Pharmacology and Cosmetology Procedures and Prevention Help to Achieve Optimal Treatment Results? A Narrative Review

Piętowska

Nowicka

Szepietowski

2022

IJERPH

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Melasma is a chronic skin condition that involves the overproduction of melanin in areas exposed to ultraviolet radiation. Melasma treatment is long-term and complicated with recurrence and resistance to treatment. The pathogenesis of melasma is highly complex with multiple pathologies occurring outside of the skin pigment cells. It includes photoaging, excessive melanogenesis, an increased number of mast cells, increased vascularization, and basement membrane damage. In addition, skin lesions related to melasma and their surrounding skin have nearly 300 genes differentially expressed from healthy skin. Traditionally, melasma was treated with topical agents, including hydroquinone, tretinoin, glucocorticosteroids and various formulations; however, the current approach includes the topical application of a variety of substances, chemical peels, laser and light treatments, mesotherapy, microneedling and/or the use of systemic therapy. The treatment plan for patients with melasma begins with the elimination of risk factors, strict protection against ultraviolet radiation, and the topical use of lightening agents. Hyperpigmentation treatment alone can be ineffective unless combined with regenerative methods and photoprotection. In this review, we show that in-depth knowledge associated with proper communication and the establishment of a relationship with the patient help to achieve good adherence and compliance in this long-term, time-consuming and difficult procedure.

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“…prace badaczy ze Stanów Zjednoczonych oraz Chin [5,10]. Długość fali lasera tulowego ma wyższy współczynnik absorpcji dla wody niż konwencjonalne lasery frakcyjne 1550 nm oraz maksymalną głębokość penetracji wynoszącą 200 μm, co przekłada się na możliwość precyzyjnego opracowania zmian w obszarze naskórka przy minimalnym uszkodzeniu skóry właściwej [12]. Mechanizm działania lasera tulowego wykorzystując wodę jako chromofor indukuje gęstą sieć mikroskopijnych, kolumnowych stref termicznego uszkodzenia tkanki z następującym "przemieszczaniem się melaniny" ze znajdującej się niżej skóry i naskórka oraz stymuluje kontrolowane gojenie i przebudowę skóry [3].…”

Section: Omówienieunclassified

“…Melasma jest szczególnie powszechna u kobiet i jej występowanie związane jest z następującymi stanami: ciąża, menopauza, zaburzenia miesiączkowania, stany zapalne przydatków, przyjmowanie doustnych leków antykoncepcyjnych, przewlekłe choroby wątroby, stosowanie niektórych leków oraz kosmetyków [2,6,7]. Według badaczy ekspozycja na słońce i ciąża są najczęstszymi czynnikami wywołującymi lub zaostrzającymi melasmę [2,5,9] i choć dokładna przyczyna powstawania ostudy jest nieznana, uważa się, że ostuda jest efektem stymulacji melanocytów i wzrostu aktywności melanogennej po ekspozycji skóry na światło ultrafioletowe ze słońca [9,12]. Badacze z Meksyku sugerują, że melasma może być wynikiem kumulacji ekspozycji na słońce i fotostarzenia skóry, w którym kluczową rolę odgrywają komórki zapalne [4].…”

unclassified

“…leczenie miejscowe środkami depigmentującymi, takimi jak hydrochinon, tretinoina, kwas azelainowy, chlorowodorek cysteaminy, kwas kojowy, peelingi chemiczne; terapię systemową uwzględniającą kwas traneksamowy, beta-karotenoidy, melatoninę i procyjanidynę [1,5]. Wyżej wymienionym terapiom, może towarzyszyć wiele negatywnych skutków ubocznych, które są zazwyczaj łagodne, a terapie często nie przynoszą optymalnych rezultatów [2,12]. Do powszechnie obserwowanych działań niepożądanych należy bliznowacenie, podrażnienie, plamy hipopigmentacyjne na skórze, suchość skóry, kontaktowe zapalenie skóry [8].…”

unclassified

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Use of combined picosecond 1064nm and thulium laser 1927nm in melasma treatment – case report

Kozińska¹,

Gras-Ozimek

2022

J Educ Health Sport

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Melasma is an acquired, chronic skin pigmentation disorder that affects mainly women and can significantly affect the quality of life and self-esteem of patients. Many therapeutic procedures have been described in the literature, nevertheless the disease is difficult to treat. A case report. The paper presents a case of successful laser treatment in a 44-year-old woman with a long history of facial skin discoloration of the type of melasma. The patient was treated with combined laser therapy in the area of facial discoloration with a picosecond laser and a thulium laser. Aim The aim of this study is to draw attention to the possibility of using laser therapy in the treatment of melasma-type skin hyperpigmentation. In this article, we describe a case of brightening of a melasma-type discoloration during a single laser treatment combining the use of a 1064nm picosecond laser and a 1927nm thulium laser, in order to meet interests of patients and physicians in the use of laserotherapy in the treatment of discoloration, especially in patients who do not tolerate well the side effects of pharmacological therapies. Conclusions. The use of laser therapy, with particular emphasis on the picosecond and thulium laser, can be an important and effective element in the treatment of melasma-type hyperpigmentation of the skin.

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Treatment of Melasma Using a Novel 1,927 nm Fractional Thulium Laser: A Retrospective Analysis of 68 Korean Patients

Cited by 5 publications

References 24 publications

Investigating the efficacy of a fractionated 1927 nm laser for diffuse dyspigmentation and actinic changes

Investigating the efficacy of a fractionated 1927 nm laser for diffuse dyspigmentation and actinic changes

Understanding Melasma-How Can Pharmacology and Cosmetology Procedures and Prevention Help to Achieve Optimal Treatment Results? A Narrative Review

Use of combined picosecond 1064nm and thulium laser 1927nm in melasma treatment – case report

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