Section : Conference Notes

Lasers for melasma: not the sharpest knives in the drawer

  • The study compares
  • trichloroacetic acid (TCA): treatment applied every 2 weeks up to 8sessions

vs

  • double frequency Q-switched Nd;YAG laser (1064nm and 532nm): treatment done once a month up to 6 sessions

Methods (and comments)

  • 65 adult female patients were included
  • Wood’s light to determine depth (sometimes unreliable)
  • Evaluation through MASI: not reliable (Link)
  • Follow up three months after the last treatment for recurrence
  • Group 1
    • epidermal location of the pigmentation
    • n (number of patients) = 15,  TCA 20%
  • Group 2
    • dermal and mixed (epidermal and dermal)
    • n=20, TCA 25%
  • Group 3
    • dermal and mixed
    • n=15, TCA 30%
  • Group 4
    • n=15:
      • 7 with epidermal with wavelength at 532nm
      • 8 dermal mixed location with wavelength at 1064nm
  • Results show that the biggest improvement (64.7% +/- 21.9%) was seem in group 2 (TCA25%).
    • The condition actaully worsened in group 4 (laser): (-49.2% +/- 66.3&)
    • Recurrence rate was 32% siimilar in all 4 groups
  • Conclusion and comment. Lasers actually worsened the melasma and this could be through the induction of post-inflammatory hyperpigmentation.

No conflicts of interest disclosed

Source of information: Alaa E. et al. P1422. Q-switched Nd:YAG laser versus trichloroacetic acid peeling in the treatment of melasma among Egyptian patients. European Academy of Dermatology and Venereology (EADV) Annual Meeting – Istanbul, Turkey, 2-6 October 2013