Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand.
Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.
J Cosmet Dermatol. 2021 Jun;20(6):1700-1708. doi: 10.1111/jocd.13756. Epub 2020 Oct 16.
The potential efficacy of vascular component-targeted laser has been evaluated for the treatment of melasma, which commonly found with the co-existence of telangiectasia.
To evaluate the treatment efficacy and safety of 585-nm QSNYL and 4% HQ cream combination vs 4% HQ cream alone for telangiectatic melasma in the skin phototypes III-V.
PATIENTS/METHODS: Twenty-one Thai female patients with telangiectatic melasma and Fitzpatrick skin phototypes (FPTs) III-V were randomly treated with the 585-nm QSNYL on one side of the face for five sessions at 2-week intervals. All patients were assigned to apply HQ cream daily at night on both sides of the face for 10 weeks and a broad-spectrum sunscreen regularly throughout the study. The treatment efficacy and safety were evaluated using the Modified Melasma Area and Severity Index (mMASI), biometric evaluation, patient assessment, and adverse effects.
The combination-treated side yielded more significant improvement of mMASI than the topical-treated side at weeks 2, 4, and 8, respectively. However, 19% of the patients developed postinflammatory hyperpigmentation (PIH) on the laser-treated side, especially in FPTs IV-V and rebound hyperpigmentation. There was a significant improvement of hemoglobin and melanin index, but without statistical difference between the two treatment groups.
The combination of 585-nm QSNYL and HQ treatment yields treatment efficacy and skin rejuvenation effects for telangiectatic melasma. Nonetheless, a high incidence of PIH and rebound hyperpigmentation is adversely developed in dark FPT. Thus, this laser treatment should be cautiously applied in those with dark FPTs IV-V to avoid laser-induced pigment alteration.
血管靶向激光的潜在疗效已在治疗黄褐斑方面得到评估，黄褐斑常伴有毛细血管扩张。
评估 585nm QSNYL 和 4% HQ 乳膏联合治疗与单独使用 4% HQ 乳膏治疗 III-V 型皮肤光型毛细血管扩张性黄褐斑的疗效和安全性。
患者/方法：21 例泰国女性毛细血管扩张性黄褐斑患者，皮肤光型（FPT）为 III-V 型，随机接受 585nm QSNYL 治疗，每 2 周治疗 1 次，共 5 次。所有患者均被分配在面部两侧每晚涂抹 HQ 乳膏，持续 10 周，并在整个研究期间定期使用广谱防晒霜。使用改良黄褐斑面积和严重程度指数（mMASI）、生物计量评估、患者评估和不良反应评估来评估治疗效果和安全性。
联合治疗组在第 2、4 和 8 周时的 mMASI 改善程度均明显优于局部治疗组。然而，19%的患者在激光治疗侧出现了炎症后色素沉着（PIH），尤其是在 FPTs IV-V 和反弹性色素沉着。血红蛋白和黑色素指数均有显著改善，但两组间无统计学差异。
585nm QSNYL 和 HQ 联合治疗对毛细血管扩张性黄褐斑具有治疗效果和皮肤年轻化效果。然而，在深色 FPT 中，PIH 和反弹性色素沉着的发生率较高。因此，在深色 FPTs IV-V 的患者中应谨慎应用这种激光治疗，以避免激光诱导的色素改变。
