Melasma is one of the most common acquired hypermelanosis of sun-exposed skin. Treatments, including hypopigmenting agents and chemical peels, are still being used, but there is still no universally recognized agent for the treatment of melasma. Recently, a Q-switched neodymium yttrium aluminum garnet laser has been proposed for this purpose. This evaluation confirms that by minimizing side effects, treatment time and costs, Q-switched neodymium yttrium aluminum garnet laser can be effective and safe for lightening skin hyperpigmentation. The biological role of cutaneous blood vessels in the pathogenesis of melasma is a very interesting topic that opens up new therapeutic perspectives.
The authors recently conducted a prospective study to evaluate the effects of pulsed dye laser treatment. After conducting a study to assess the components of hemoglobin and melanin, the authors now use a vascular laser with a low radiation density and have achieved certain improvements. By targeting vascularization and at least some of the elastosis in melasma lesions, it will be possible to reduce melanocyte stimulation and thus reduce the occurrence of relapses.
Hyperpigmentation disorders, especially melasma, as well as other forms of primary and secondary hyperpigmentation, can cause emotional and social stress in patients. Getting rid of these problems is usually not easy due to the lack of successful treatment options available today. Today, various treatments are used, which can be divided into topical and cosmetic (with depigmenting agents such as hydroquinone, methimazole, pidobenzone, tretinoin, arbutin, azelaic acid, ellagic acid, mkinol, ascorbic acid and resveratrol), applied alone or in combination. combined with chemical peels or physical treatments.
Laser devices have revolutionized the treatment of many dermatological diseases, including pigmentation disorders. They are widely used with varying levels of efficacy for pigmentation problems such as Becker's nevus, birthmarks, nevus of Ota, neocellular nevus, lentigines, tattoos, melasma, and post-inflammatory hyperpigmentation. Although the treatment of many pigmentation problems has shown good results, the effectiveness and safety of lasers for the treatment of melasma is still in question. Most authors consider chemical peels to be the most effective treatment for melasma.
Laser therapy for pigmented lesions is based on the theory of selective photothermolysis, which consists in directing the wavelength of energy in a shorter period of time than the thermal relaxation time of the target chromophore. This means that the energy is directed precisely at the target, thus causing less damage to the surrounding tissue. The range of choice for targeting melanin is between 630 nm and 1100 nm, which provides good skin penetration and absorption of melanin rather than oxyhemoglobin. Melanin absorption decreases as the wavelength increases, and longer wavelengths allow deeper penetration into the skin. Shorter wavelengths (˂ 600 nm) damage pigmented cells using less energy, while longer wavelengths (˃ 600 nm) penetrate deeper but require more energy, to damage melanocytes.
According to Prime magazine.
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