Erbium:YAG laser resurfacing for refractory melasma.

Area of Science:

• Dermatology
• Aesthetic Medicine
• Laser Surgery

Background:

• Melasma is a prevalent facial dyspigmentation, particularly affecting individuals with darker skin tones.
• Existing treatments for melasma often yield suboptimal results and can lead to adverse effects.

Purpose of the Study:

• To assess the efficacy of erbium:YAG laser resurfacing for managing melasma resistant to conventional therapies.
• To evaluate the safety profile and clinical outcomes of this laser treatment in refractory melasma cases.

Main Methods:

• Ten female patients with refractory melasma underwent full-face skin resurfacing with an erbium:YAG laser (2.94 µm) at 5.1–7.6 J/cm².
• Clinical assessments included the Melasma Area and Severity Index (MASI) and melanin reflectance spectrometry, measured preoperatively and at multiple postoperative intervals up to 6 months.
• Adverse effects such as erythema, infection, and hyperpigmentation were meticulously recorded.

Main Results:

• Immediate improvement in melasma was observed post-laser treatment.
• Transient post-inflammatory hyperpigmentation occurred in all patients between 3 and 6 weeks postoperatively.
• Significant clinical improvement in melasma was evident at 6 months, particularly with concurrent biweekly glycolic acid peels, indicated by decreased MASI and melanin reflectance scores.

Conclusions:

• Erbium:YAG laser resurfacing is an effective modality for improving refractory melasma.
• The high incidence of transient post-inflammatory hyperpigmentation necessitates proactive and consistent management.
• This laser treatment is recommended exclusively for recalcitrant cases of melasma.