alexa Combination of fractional erbium-glass laser and topical therapy in melasma resistant to triple-combination cream.
Dermatology

Dermatology

Dermatology and Dermatologic Diseases

Author(s): Tourlaki A, Galimberti MG, Pellacani G, Bencini PL

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Abstract BACKGROUND: Melasma is a common melanosis often difficult to treat. OBJECTIVE: The aim of this paper was to report on the safety and efficacy of non-ablative fractional photothermolysis combined with the use of triple-combination cream (TCC) on a large population with melasma resistant (i.e., with no complete/near-complete clearing) to TCC alone. METHODS: Seventy-six patients with resistant melasma underwent a combined treatment protocol. The protocol consisted of a TCC (hydroquinone 4\%, retinoic acid 0.03\%, hydrocortisone butyrate 0.1\%) applied daily for 10 days followed by four laser treatments performed in 3-week intervals with a fractional 1540-nm erbium-glass laser. During these intervals, and for 3 months after the last laser session, TCC was also applied daily following a "pulse-therapy" scheme. Improvement was assessed by the melasma-area-and-severity-index (MASI) score. RESULTS: At 1 month, marked (>75\%) and moderate (51-75\%) clearing of melasma were observed in 46 of 76 (67.1\%) and 12 of 76 (21\%) cases, respectively. At 6 months, we noticed a marked improvement in 16 of 76 (21.1\%) and no improvement in 33 of 76 (43.4\%) patients. CONCLUSION: Our study proposes the combination of NFP/TCC as a useful therapy for patients with melasma resistant to TCC alone, but it shows that its long-term efficacy is limited. This article was published in J Dermatolog Treat and referenced in Dermatology and Dermatologic Diseases

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