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Laser therapy and skin hyperpigmentation

Elizabeth R C Geddes, Ashlyn B Stout, Paul M Friedman
BACKGROUND: Melasma presents a significant challenge to laser surgeons. Aggressive treatments often result in rebound melasma or post-inflammatory pigmentary alteration. Recent reports suggest melasma pathogenesis may have a vascular component. Spectrocolorimetry can detect subtle or sub-clinical telangiectatic erythema within melasma lesions. For certain patients identified by spectrocolorimetry, effective melasma treatment may include vascular-targeted therapy together with pigment-specific treatment modalities...
January 2017: Lasers in Surgery and Medicine
Mohammad Taraz, Somayeh Niknam, Amir Houshang Ehsani
Melasma is a human melanogenesis dysfunction that results in localized, chronic acquired hyperpigmentation of the skin. It has a significant impact on appearance, causing psychosocial and emotional distress, and reducing the quality of life of the affected patients. Tranexamic acid (TA) is a plasmin inhibitor used to prevent abnormal fibrinolysis to reduce blood loss and exerts its effect by reversibly blocking lysine binding sites on plasminogen molecules, thus inhibiting plasminogen activator (PA) from converting plasminogen to plasmin...
January 30, 2017: Dermatologic Therapy
Lucija Kroepfl, Jason J Emer
Acne is one of the most prevalent skin conditions seen by dermatologists. The cosmetic sequelae of severe acne, including scarring and pigmentation, have a profound psychological impact on those in icted. Topical (eg, retinoids, antibiotics, dapsone, hydroxyacids) and oral treatments (eg, antibiotics and/or spironolactone) are often bene cial to control acne or in the instance of oral isotretinoin use, rid the acne permanently; however, these treatments have very little affect on the ultimate cosmetic outcome of the acne scarring and skin texture that results...
November 1, 2016: Journal of Drugs in Dermatology: JDD
Murad Alam
Lasers and light sources, as well as other energy devices, including radiofrequency, ultrasound, and cold-based therapies, can be used for treatment of aging, dyschromic, or texturally uneven skin. In patients with ethnic skin (ie, skin of color), energy devices are used more cautiously to avoid adverse events. The most common and concerning adverse event is postinflammatory hyperpigmentation. Lower fluence, longer pulse durations, and careful device selection can mitigate the risk of scarring and pigmentary abnormality...
December 2016: Seminars in Cutaneous Medicine and Surgery
You Jin Lee, Ji Hye Park, Dong Youn Lee, Jong Hee Lee
Facial dyspigmentation in Asian women often poses diagnostic and therapeutic challenges. Recently, a distinctive bilateral hyperpigmentation of face and neck has occasionally been observed. This study was performed to investigate the clinico-pathological features of this dyspigmentation as well as proper treatment approaches. We retrospectively investigated the medical records including photographs, routine laboratory tests, histopathologic studies of both lesional and peri-lesional normal skin and patch test of thirty-one patients presented acquired bizarre hyperpigmentation on face and neck...
December 2016: Journal of Korean Medical Science
Yasmeen Jabeen Bhat, Iffat Hassan, Peerzada Sajad, Atiya Yaseen, Syed Mubashir, Saniya Akhter, Roohi Wani
BACKGROUND: Epidermal naevi are benign hamartomatous growths of the skin which are generally asymptomatic with a benign course but are cosmetically disagreeable. Topical treatments such as steroids, calcipotriol, 5 fluorouracil, podophyllin, retinoids and cryotherapy are ineffective and surgical excision results in scar formation. Therapy is often challenging. AIM OF THE STUDY: To study the response of carbon dioxide (CO2) laser in the management of epidermal naevi...
July 2016: Journal of Cutaneous and Aesthetic Surgery
Anna Campanati, Melania Giannoni, Alessandro Scalise, Simona De Blasio, Angela Giuliano, Katia Giuliodori, Giulia Ganzetti, Elisa Bolletta, Giovanni Di Benedetto, Annamaria Offidani
BACKGROUND/OBJECTIVE: This study aims at the evaluation of the efficacy and safety of a combination therapy based on pidobenzone 4% and fractional CO2 laser or cryotherapy in the treatment of solar lentigines and the prevention of eventual posttreatment hyperchromia. METHODS: Efficacy was clinically evaluated by grading the pigmentation level with the Skin Tone Color Scale (STCS), and by grading patients' impression through a Visual Analog Scale (VAS). RESULTS: Our study shows that the associated treatment was safe and that it improves the therapeutic results on solar lentigines and prevents postiatrogenic hyperpigmentation compared with physical therapy alone...
2016: Dermatology: International Journal for Clinical and Investigative Dermatology
Baishuang Yue, Qianli Yang, Jinhua Xu, Zhong Lu
Melasma is an acquired disorder of symmetrical hyperpigmentation commonly seen in patients with Fitzpatrick skin types III and IV. Various novel therapeutic modalities have emerged to treat melasma. The large-spot low-fluence QS Nd:YAG laser has been widely used in Asia; however, the modality needs to be optimized because of the high recurrence rate. The objective of this study is to explore the clinical efficacy and safety of fractional-mode (Pixel) Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) 1064-nm laser for treatment of melasma in Chinese patients...
November 2016: Lasers in Medical Science
Jen-Hsiang Shen, Chang-Cheng Chang, Yu-Tsung Chen, Chao-Jen Hsih, Hsin Huang, Bor-Shyh Lin
BACKGROUND AND OBJECTIVES: Low fluence Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers are widely applied for facial depigmentation. Nonetheless, few reports analyze the general outcome, complications, of single and combined therapy of 532/1064-nm Nd:YAG lasers in Asian patients with Fitzpatrick type IV skin. STUDY DESIGN/MATERIALS AND METHODS: We retrospectively reviewed all consecutive patients who completed 5 consecutive sessions at 1-month intervals of treatment with 1064-nm (spot size: 5-7 mm, 1...
February 2016: Annals of Plastic Surgery
Laurence Imhof, Reinhard Dummer, Jil Dreier, Isabel Kolm, Marjam J Barysch
BACKGROUND: Quality-switched (QS) laser therapy is a safe and well-established treatment option for removing solar lentigines. Triple combination therapy (TCT) with the active pharmaceutical ingredients hydroquinone 5%, tretinoin 0.03%, and dexamethasone 0.03% is often used for skin-lightening. OBJECTIVE: This prospective, open-label trial compares the efficacy and safety of a QS Ruby laser (QSRL) and a TCT in the treatment of solar lentigines. METHODS: In total, 15 patients with symmetrically distributed solar lentigines on the back of both hands were included...
July 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Dawn Zhang Eichenfield, Philip Cohen
BACKGROUND: Several drugs can be associated with hyperpigmentation of mucosa or skin. They include antibiotic, antimalarial, antineoplastic, and psychotropic medications. PURPOSE: To describe a 42-year-old woman with amitriptyline-associated photo-distributed hyperpigmentation and to review psychotropic drug-induced hyperpigmentation of the skin. MATERIALS AND METHODS: The features of a woman with amitriptyline-induced hyperpigmentation are presented...
February 17, 2016: Dermatology Online Journal
Yujin Ahn, Chan-Young Lee, Songyee Baek, Taeho Kim, Pilun Kim, Sunghoon Lee, Daejin Min, Haekwang Lee, Jeehyun Kim, Woonggyu Jung
Nowadays, laser therapy is a common method for treating various dermatological troubles such as acne and wrinkles because of its efficient and immediate skin enhancement. Although laser treatment has become a routine procedure in medical and cosmetic fields, the prevention of side-effects, such as hyperpigmentation, redness and burning, still remains a critical issue that needs to be addressed. In order to reduce the side-effects while attaining efficient therapeutic outcomes, it is essential to understand the light-skin interaction through evaluation of physiological changes before and after laser therapy...
March 1, 2016: Biomedical Optics Express
B Sofen, G Prado, J Emer
Dyschromia is a leading cause for cosmetic consultation, especially in those with diverse skin types (mixture of ethnicities) and with the rise of non-core and untrained physicians performing cosmetic procedures. Melasma and post-inflammatory hyperpigmentation (PIH) account for the majority of cases and are characterized by pigmented macules and patches distributed symmetrically in sun-exposed areas of the forehead, cheeks, and chin in melasma, and irregularly in areas of inflammation or an inciting traumatic event with PIH...
January 2016: Skin Therapy Letter
Jennifer D Peterson, Suzanne L Kilmer
BACKGROUND: Photodamaged skin of the chest is characterized by skin laxity, lines/wrinkles, hyperpigmentation, erythema, tactile roughness, atrophy, and telangiectasias. METHODS: A MEDLINE search was performed on combination treatments in chest rejuvenation, and the results are summarized. Practical applications for these combinations of procedures are discussed. RESULTS: Reports of injectable poly-L-lactic acid (PLLA), hyaluronic acid (HA), and chemical peels, along with lasers and light therapies such as intense pulsed light (IPL), vascular lasers, photodynamic therapy (PDT), nonablative fractionated lasers (NAFLs), ablative fractionated lasers (AFLs), and microfocused ultrasound (MFU) have been reported for chest rejuvenation...
May 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Rashmi Sarkar, Rashmi Ranjan, Shilpa Garg, Vijay K Garg, Sidharth Sonthalia, Shivani Bansal
Periorbital hyperpigmentation is a commonly encountered condition. There is very little scientific data available on the clinical profile and pathogenesis of periorbital hyperpigmentation. Periorbital hyperpigmentation is caused by various exogenous and endogenous factors. The causative factors include genetic or heredity, excessive pigmentation, postinflammatory hyperpigmentation secondary to atopic and allergic contact dermatitis, periorbital edema, excessive vascularity, shadowing due to skin laxity and tear trough associated with aging...
January 2016: Journal of Clinical and Aesthetic Dermatology
Adele Haimovic, Jeremy A Brauer, Yoon-Soo Cindy Bae, Roy G Geronemus
BACKGROUND: Laser therapy in patients with skin of color is associated with an increased rate of complications. The 755-nm picosecond laser with the diffractive lens array (DLA) has been used for the treatment of scars, striae, and rejuvenation. By delivering high energy to focused areas, the DLA minimizes complications. OBJECTIVE: This study explores the adverse events associated with treatment with the 755-nm picosecond laser with DLA in individuals with Fitzpatrick skin type IV to VI...
May 2016: Journal of the American Academy of Dermatology
Wei Cheng Brian Anthony Tian
Melasma is one of the most common pigmented lesions in Chinese women. Although topical therapies are the mainstay treatment, lasers are being used increasingly to treat pigmented lesions. Laser treatment of melasma is however still controversial. This is because lasers have not been able to produce complete clearance of melasma and recurrence rates are high. Laser treatments also cause complications such as hypopigmentation and post-inflammatory hyperpigmentation. In this article, we report on a novel technique using a combination of fractional 2940-nm Er:YAG and 1064-nm Q-switched Nd:YAG lasers...
2016: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
Ji-Hye Park, Jung-In Kim, Won-Serk Kim
BACKGROUND: Postinflammatory hyperpigmentation (PIH) is an acquired hypermelanosis induced by various causes including inflammatory dermatoses, injury, or cosmetic procedures, such as lasers or chemical peels, and it tends to affect dark-skinned people with greater frequency and severity. There are a variety of treatment options for PIH, including topical agents, chemical peels, laser, and light therapy. However, the results are not up to expectation. OBJECTIVE: The purpose of this study was to examine the clinical efficacy and safety of novel pulse-in-pulse mode intense pulsed light (IPL) for the treatment of persistent facial PIH in Korean patients...
February 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
C Bayerl
BACKGROUND: Homogenous pigmentation can be induced by α-melanocyte-stimulating hormone (MSH) homologues. Cosmetically inacceptable pigmentation is mostly located on the face. OBJECTIVES: Although afamelatonide is a prescription drug for the orphan disease erthropoetic protoporphyria, structurally related α-MSH derivatives are available via the internet. Preventive and therapeutical options are necessary for postinflammatory hyperpigmentation, melasma, and lentigines...
October 2015: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Li Tao, Jiaqiang Wu, Hui Qian, Zhong Lu, Yuanhong Li, Weizhen Wang, Xiaozhong Zhao, Ping Tu, Rui Yin, Leihong Xiang
Ablative skin rejuvenation therapies have limitations for Asian people, including post-inflammatory hyperpigmentation and long down time. Non-ablative lasers are safer but have limited efficacy. This study is to investigate the safety and efficacy of a combination therapy consisting of intense pulsed light (IPL), near infrared (NIR) light, and fractional erbium YAG (Er:YAG) laser for skin rejuvenation in Asian people. This study recruited 113 subjects from six sites in China. Subjects were randomly assigned to a full-face group, who received combination therapy, and split-face groups, in which one half of the face received combination therapy and the other half received IPL monotherapy...
September 2015: Lasers in Medical Science
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