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皮肤色素沉着过度的多模式管理

Multimodality Management of Skin Hyperpigmentation.

作者信息

Almansory Amer Salman, Alhamdany Zainab Salem

机构信息

College of Medicine, University of Basrah, Basra, Iraq.

Alsader Teaching Hospital, Basrah, Iraq.

出版信息

Aesthetic Plast Surg. 2025 Jul;49(13):3776-3784. doi: 10.1007/s00266-025-04866-0. Epub 2025 Apr 29.

DOI:10.1007/s00266-025-04866-0
PMID:40301200
Abstract

BACKGROUND

Skin hyperpigmentation, caused by excessive melanin production, presents both aesthetic and psychological concerns. The Q-switched Nd:YAG laser is a key treatment modality, with effectiveness influenced by factors such as skin type, laser fluence, and treatment frequency. A multimodal approach combining laser therapy and medical treatment may enhance outcomes.

OBJECTIVES

This study evaluates the efficacy and safety of Q-switched Nd:YAG laser combined with medical therapy for hyperpigmentation, focusing on clinical outcomes and patient satisfaction.

METHODS

A randomized cross-sectional study was conducted on 300 patients in private clinics from January 2022 to September 2023. Treatment response was assessed through clinical evaluations and patient-reported satisfaction using the Likert scale. The impact of factors such as gender, sun exposure, pregnancy, and hormonal influences was analyzed.

RESULTS

The majority of participants were female (92.6%). Clinical evaluation and patient satisfaction improved significantly over successive sessions, with "Good" satisfaction ratings increasing from 80.6% initially to 98.3% at study completion. Male patients demonstrated a stronger response to treatment than females. No significant impact of the studied factors on outcomes was identified.

CONCLUSIONS

A comprehensive assessment of hyperpigmentation is crucial for optimal treatment selection. A multimodal approach combining Q-switched Nd:YAG laser and medical therapy yields superior results compared to single-modality treatments, with outcomes improving progressively across sessions.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

摘要

背景

由黑色素过度生成引起的皮肤色素沉着,在美学和心理方面都令人担忧。调Q Nd:YAG激光是一种关键的治疗方式,其疗效受皮肤类型、激光能量密度和治疗频率等因素影响。将激光治疗与药物治疗相结合的多模式方法可能会提高治疗效果。

目的

本研究评估调Q Nd:YAG激光联合药物治疗色素沉着的疗效和安全性,重点关注临床疗效和患者满意度。

方法

2022年1月至2023年9月,在私人诊所对300名患者进行了一项随机横断面研究。通过临床评估和使用李克特量表的患者报告满意度来评估治疗反应。分析了性别、日晒、怀孕和激素影响等因素的作用。

结果

大多数参与者为女性(92.6%)。在连续治疗过程中,临床评估和患者满意度显著改善,“良好”满意度评分从最初的80.6%增加到研究结束时的98.3%。男性患者对治疗的反应比女性更强。未发现所研究的因素对治疗结果有显著影响。

结论

对色素沉着进行全面评估对于选择最佳治疗方法至关重要。与单一治疗方式相比,调Q Nd:YAG激光联合药物治疗的多模式方法产生了更好的效果,且治疗效果在各疗程中逐步改善。

证据级别III:本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述,请参阅目录或作者在线指南 www.springer.com/00266 。

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