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Laser resurfacing-induced hypopigmentation: histologic alterations and repigmentation with topical photochemotherapy
1Vitiligo and Pigmentation Institute of Southern California, Los Angeles, CA 90004, USA.
Summary
Hypopigmentation after CO2 laser resurfacing may stem from reduced melanogenesis, not melanocyte loss. Topical psoralen photochemotherapy effectively treated this side effect in most patients with minimal adverse effects.
Area of Science:
- Dermatology
- Laser Therapy
- Photochemotherapy
Background:
- Hypopigmentation is a common, often permanent side effect of CO2 laser resurfacing.
- Histologic features of laser-induced hypopigmentation are not well understood.
- Current understanding considers hypopigmentation a permanent complication.
Purpose of the Study:
- To histologically assess laser resurfacing-induced hypopigmentation.
- To evaluate the efficacy and safety of topical psoralen photochemotherapy for this condition.
Main Methods:
- Pilot study including 10 patients with laser-induced hypopigmentation.
- Baseline biopsies analyzed for melanin, melanocytes, inflammation, and fibrosis.
- Seven patients treated with 0.001% 8-methoxypsoralen twice weekly.
Main Results:
- Biopsies showed epidermal melanin and melanocytes, suggesting suppressed melanogenesis.
- Superficial dermal fibrosis was present in all specimens.
- Topical photochemotherapy achieved moderate to excellent repigmentation in 71% of patients with minimal side effects.
Conclusions:
- Laser resurfacing-induced hypopigmentation may result from suppressed melanogenesis, not melanocyte destruction.
- Topical psoralen photochemotherapy shows promise for treating this condition.
- Further investigation into this treatment modality is warranted.