Melasma and laser treatment: an evidenced-based analysis

Area of Science:

• Dermatology
• Aesthetic Medicine
• Photomedicine

Background:

• Melasma treatment often involves various modalities, with laser therapy being explored.
• Limited consensus exists on the safety, efficacy, and durability of laser treatments for melasma.
• Potential risks associated with laser interventions in hyperpigmented skin necessitate risk-benefit analysis.

Purpose of the Study:

• To systematically review the literature on light-based therapies for melasma.
• To evaluate the safety, efficacy, and durability of laser treatments compared to conventional approaches.
• To determine if laser therapy is a recommended treatment for melasma.

Main Methods:

• Analysis of English language literature focusing on light-based therapy for melasma.
• Inclusion of prospective, controlled studies with at least 10 participants.
• Inclusion of studies presenting objective and quantitative data.

Main Results:

• Seven studies met the inclusion criteria; two used melanin-targeting lasers, five used fractional photothermolysis.
• Laser treatment response was inconsistent across studies.
• Adverse events, including hyperpigmentation, were reported.
• Durability of improvement was limited with laser monotherapy.
• Laser monotherapy showed no significant benefit over topical treatments in comparative studies.

Conclusions:

• Laser therapy for melasma is not recommended due to unpredictable safety and efficacy.
• Limited duration of clinical improvement and lack of clear benefit over conventional treatments support this conclusion.
• Further research may be needed to establish the role of lasers in melasma management.