Ann Dermatol.  2017 Dec;29(6):779-781. 10.5021/ad.2017.29.6.779.

Treatment of Melasma and Post-Inflammatory Hyperpigmentation by a Picosecond 755-nm Alexandrite Laser in Asian Patients

• Lee YJ
• Shin HJ
• Noh TK
• Choi KH
• Chang SE

• KMID: 2395188
• DOI: http://doi.org/10.5021/ad.2017.29.6.779

Abstract

The picosecond lasers have shown to effectively treat tattoo pigments that are intractable to previous multiple Q-switched (QS) laser treatments. Therefore we hypothesized that a picosecond laser would show better efficacy with minimal adverse events in the treatment of melasma and post-inflammatory hyperpigmentation (PIH) that are difficult to treat with conventional QS lasers. Two patients with melasma and one patient with PIH were treated with a Picosecond 755-nm Alexandrite Laser (Cyanosure, USA). All patients were Korean with skin type IV and no longer responding to QS laser treatments. Laser treatment was well tolerated in all the patients. Adverse events such as PIH were not reported during 8 weeks of follow up period. After the multiple treatment sessions, one patient reported fair improvement and two patients reported good improvement. Consistent with the clinical results, ex vivo skin model irradiated with a Picosecond 755-nm Alexandrite Laser also showed decreased epidermal keratinocyte necrosis compared with the 532-nm QS Neodymium-Doped Yttrium Aluminium Garnet Laser (Lutronic, Korea) yet decreased melanin content. In conclusion, the Picosecond 755-nm Alexandrite Laser may be useful for effective treatment of intractable melasma and PIH with fewer adverse events in dark Asian skin.

Keyword

Melanosis; Picosecond laser; Postinflammatory hyperpigmentation

MeSH Terms

Asian Continental Ancestry Group*
Follow-Up Studies
Humans
Hyperpigmentation*
Keratinocytes
Lasers, Solid-State*
Melanins
Melanosis*
Necrosis
Skin
Yttrium
Melanins
Yttrium

Figure

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  Fig. 1 Melasma in a 53-year-old female. (A) Findings at baseline. (B) Findings after six treatments of 0.57 J/cm2 with a 6-mm spot size using a Picosecond 755-nm Alexandrite Laser.

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  Fig. 2 Melasma in a 45-year-old female. (A) Findings at baseline. (B) Findings after 14 treatments of 0.57 J/cm2 with a 6-mm spot size using a Picosecond 755-nm Alexandrite Laser.

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  Fig. 3 Post-inflammatory hyperpigmentation in a 20-year-old female. (A) Findings at baseline. (B) Findings after seven treatments of 5.25 J/cm2 with a 2-mm spot size using a Picosecond 755-nm Alexandrite Laser.

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  Fig. 4 (A~D) Photomicrographs of a skin model stained for nitro blue tetrazolium after laser treatment: (A) control, (B) 1,064-nm Q-switched Neodymium-Doped Yttrium Aluminium Garnet (QSNY) Laser, (C) 532-nm QSNY Laser, (D) Picosecond 755-nm Alexandrite Laser; A~D, ×200). (E) Relative value of melanin index seven days after treatment. Quantitative measurement of melanin pigments was performed using Image J analysis following Fontana-Masson staining.

Reference

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