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Keywords:

  • melasma;
  • fractional laser;
  • thulium laser

Abstract

Background

Melasma is a common acquired symmetrical hyperpigmentation that is often recurrent and refractory.

Objectives

To investigate the efficacy and safety of a single administration of high-density fractional thulium fiber laser (1,927 nm) for the treatment of refractory melasma in 20 patients.

Materials and Methods

A retrospective chart and photographs review of 20 women (Fitzpatrick skin type II–IV) with clinical diagnosis of melasma treated with the 1,927-nm fractionated thulium laser at 10 or 20 mJ/cm2, with 60–70% surface area coverage. Four investigators independently evaluated Melasma Area Severity Index (MASI) scores before, 4 weeks, 3–6 months, and 6–12 months after treatment.

Results

Mean MASI scores decreased dramatically from 13.2 ± 5.4 before treatment to 8.5 ± 3.5 at 4 weeks after laser treatment (P = 0.004). Patient assessment revealed that 12 of the 20 subjects had more than 50% clearance of their melasma. Recurrence was reported by 7 out of 15 patients who were successfully followed-up (mean 10.2 months). Two patients developed postinflammatory hyperpigmentation that subsided with topical bleaching after 3 months.

Conclusion

High-density coverage fractional 1,927-nm thulium laser proved to be safe and effective for melasma with long-term remission. Lasers Surg. Med. 45: 95–101, 2013. © 2012 Wiley Periodicals, Inc.