Li Janet Y, Geddes Elizabeth Rc, Robinson Deanne M, Friedman Paul M
Department of Dermatology, University of Texas, McGovern School of Medicine and MD Anderson Cancer Center, Houston, Texas, USA.
Dermatology and Laser Surgery Center, Houston, Texas, USA.
Semin Cutan Med Surg. 2016 Dec;35(4):223-232. doi: 10.12788/j.sder.2016.060.
Melasma is a pigmentary disorder of unclear etiology with numerous treatment options and high recurrence rates. Laser and light therapies may be utilized cautiously as second- or third-line options for recalcitrant melasma, but low-energy settings are preferred due to the risk of postinflammatory hyperpigmentation and melasma stimulation. Commonly used lasers include the low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser, nonablative fractionated lasers, and intense pulsed light. Strict sun protection, concomitant use of bleaching agents, and maintenance treatments are necessary. A variety of other treatments that may also help to improve results are now being more widely adopted, including oral tranexamic acid, pulsed dye laser, antioxidants, and laser-assisted drug delivery.
黄褐斑是一种病因不明的色素沉着紊乱疾病，有多种治疗方法且复发率高。激光和光疗法可谨慎用作顽固型黄褐斑的二线或三线治疗选择，但由于存在炎症后色素沉着和黄褐斑激发的风险，首选低能量设置。常用的激光包括低能量密度的1064纳米调Q掺钕钇铝石榴石激光、非剥脱性分次激光和强脉冲光。严格的防晒、同时使用漂白剂以及维持治疗是必要的。现在，多种其他可能有助于改善治疗效果的治疗方法正得到更广泛应用，包括口服氨甲环酸、脉冲染料激光、抗氧化剂以及激光辅助药物递送。
