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Long-pulsed alexandrite laser moderately effective in treating melasma

Long-pulsed alexandrite laser with a fractional hand piece produced moderately effective results in treating women with melasma, according to recently published study results.

Researchers studied 48 Korean women with melasma (mean age, 44.1 years) who were treated with two to four sessions of fractional, 755-nm long-pulsed alexandrite laser (Noblex, FineMEC) with 2- to 3-week intervals. Twenty-seven women had Fitzpatrick skin type 3, and 21 women had Fitzpatrick skin type 4, with the mean duration of melasma of 10.5 ± 8.7 years.

Settings of 60 to 80 J/cm² without a dynamic cooling device using a 15-mm spot size of a fractional hand piece, along with a 0.5- to 1-millisecond pulse width were used to treat lesions.

Compared with baseline, there was a significant decrease the mean modified melasma area and severity index score 2 months after final treatment (16.5 ± 8.2 vs. 11.5 ± 7; P = .002), indicating a 30.5% reduction in the mean score. When compared with patients with dermal type of melasma, the patients with epidermal type of melasma displayed significant improvement in mean modified melasma and severity index score (P < .001).

Twenty patients (41.7%) showed 51% to 75% improvement, while 15 patients (31.3%) patients showed 26% to 50% improvement using the quartile grading scale.

Improvements were rated excellent by 10.4% of patients, while good-or-fair improvement was reported by 70.8% of patients.

Mild erythema and a heating sensation were minor adverse events developed by patients within 1 day. Postinflammatory hyperpigmentation was reported by one patient, with improvement at 2-month follow-up.

“A fractional, long-pulsed 755-nm alexandrite laser was adapted for the treatment of melasma in patients with a Fritzpatrick skin type 3 or 4,” the researchers concluded. “It is believed that long-pulsed alexandrite laser is effective and has few side effects in the treatment of melasma. However, as the outcome of monotherapy with the long-pulsed alexandrite laser was not completely satisfactory for patients, and because the melasma subtype affected the efficacy of long-pulsed alexandrite laser, a combination with other modalities, such as topical agents and chemical peels, may be needed to optimize the management in unsatisfactory cases.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.