Laser alone or with peel effective for mixed melasma

(HealthDay)—Low-fluence Q-switched Nd-YAG laser alone or with modified Jessner's peel are equally effective regimens for mixed melasma hyperpigmentation, according to a study published online Oct. 22 in the Journal of Cosmetic Dermatology.

Fatma Saleh, M.D., from Minia University in Egypt, and colleagues compared the efficacy of Q-switched Nd-YAG laser alone or with modified Jessner's peel in mixed melasma in dark skin. Nineteen patients received six sessions of laser on the left side of the face and alternating laser and modified Jessner's on the right side. Clinical evaluation was performed through modified melasma area and severity index at one month after the last session. Histopathological, immunohistochemical, and computerized morphometric analysis were used for assessments.

The researchers found that there was significant clinical improvement on both sides of the face without a significant difference between the two sides. Ill-defined mottled hypopigmentation was observed in 21.05 percent of patients at the sixth laser session on the left side of the face. After two treatment modalities, histopathologically, melanin particle surface area and number of MART-1-positive cells (total, epidermal, and dermal) were significantly decreased without significant difference in the reduction percentage between both sides of the face.

"Combined method is preferred, especially in dark skin, for obtaining better cosmetic result with fewer side effects of multiple laser sessions and decreasing cost rate of laser," conclude the authors.

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