Pulsed dye laser versus intense pulsed light in melasma: a split-face comparative study.

BACKGROUND: Recent reports suggest that melasma may have a vascular component. Vascular targeting lasers and light treatment can be a therapeutic option that will provide benefits to the patients.

OBJECTIVES: To compare the efficacy and tolerability of pulsed dye laser (PDL) and intense pulsed light in treatment of melasma.

PATIENTS AND METHODS: Twenty-eight Egyptian female patients with melasma were treated with PDL on the right hemiface (Group A) and with the intense pulsed light on the left hemiface (Group B). Clinical assessment was performed according to the hemifacial modified Melasma Area and Severity Index score (mMASI). Tissue biopsies were taken from patients for immunohistochemical staining with vascular endothelial growth factor (VEGF) antibody.

RESULTS: The hemifacial mMASI score was significantly reduced after treatment in studied groups with no statistically significant difference. Intense pulsed light (IPL) group showed higher efficacy of treatment than PDL group in the epidermal melasma and in melasma lesions which had a vascular component. The expression level and intensity score of VEGF were significantly reduced after treatment in both groups.

CONCLUSIONS: Both PDL and IPL were effective and safe treatment modalities for lightening of melasma. VEGF can be proved as a possible mechanism underlying the action of both PDL and IPL on melasma.