Back to Search Results

Prospective randomized controlled trial comparing treatment efficacy and tolerance of picosecond alexandrite laser with a diffractive lens array and triple combination cream in female asian patients with melasma.

Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan. School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. Department of Dermatology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan. School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan. Aletheia Holistic Dermatology Center, Taichung, Taiwan. Institute of Imaging and Biomedical Photonics, National Chiao Tung University, Tainan, Taiwan. Department of Cosmeceutics and Graduate Institute of Cosmeceutics, China Medical University Hospital, Taichung, Taiwan. Yung-Hsueh Huang Dermatology Clinic, Changhua, Taiwan. Department of Applied Cosmetology & Master's Program of Cosmetic Science, Hung Kuang University, Taichung, Taiwan. Aesthetic Medical Center, China Medical University Hospital, Taichung, Taiwan.

Journal of the European Academy of Dermatology and Venereology : JEADV. 2020;(3):624-632
Full text from:

Other resources

Abstract

BACKGROUND Recent evidence suggests melasma to be a photoaging disorder. Triple combination creams (TCC: fluocinolone acetonide 0.01%, hydroquinone 4% and tretinoin 0.05%) remain the gold standard treatment. Picosecond alexandrite laser treatment using a diffractive lens array (DLA) has been identified to be effective for improving photoaging conditions. OBJECTIVE We aimed to compare the efficacy and tolerance of the picosecond alexandrite laser with those of DLA and TCC in female Asian patients with melasma. METHODS Twenty-nine patients were randomly assigned to group A1 (3 laser sessions at 4-week intervals), A2 (5 laser sessions at 4-week intervals) or B (TCC daily for at least 8 weeks and then tapered until the final evaluation). The Melasma Area, Severity Index (MASI) score and VISIA were assessed at baseline, week 12 and week 20. By week 20, the follow-up periods for groups A1 and A2 were 3 months and 1 month, respectively. RESULTS Nine, 11 and 6 participants in groups A1, A2 and B completed the study, respectively. MASI scores were significantly improved in all 3 groups at weeks 12 and 20. In groups A1, A2 and B, the improvement rates at week 20 were 53%, 38% and 50%, respectively. VISIA® analysis additionally revealed a significant improvement in spots, porphyria, pores and brown spots after 3 laser sessions (P < 0.05). Group A2 showed greater improvements than group A1 in terms of spots, wrinkles and pores; however, only red areas were significantly different (P < 0.001). All side-effects in the 3 groups were transient and gradually subsided after 1-3 months. CONCLUSION Picosecond alexandrite laser treatment using DLA showed comparable efficacy with TCC for the treatment of melasma. Improvements in texture, spots, wrinkles and pores were observed in the laser groups. Patients with melasma lesions that exhibit telangiectasia may benefit from additional laser treatment sessions.

Methodological quality

Metadata