Drug-laser-photon therapy works well for treating melasma: Study

CHINA: A study published in the Journal of Cosmetic Dermatology demonstrates the effectiveness and safety profile of the drug-laser-photon therapy combination systemic treatment for melasma patients.

A frequent post-escity pigmentation disease called melasma is distinguished by uneven pigmentation on both sides. Melasma presents a significant problem to plastic surgeons due to its high frequency, lack of a successful treatment, and high recurrence rate. Although there is no treatment that has been proven to be the best option, combined therapy is advised.

"Numerous studies have demonstrated the potential effectiveness of combination therapy, such as taking tranexamic acid while receiving laser treatment. There are, however, few studies that use large samples and repeatable observations "according to Wei-Qiang Tan, MD, the team at the Zhejiang University School of Medicine, and department of plastic surgery.

The researchers assessed the clinical effectiveness and safety of a novel systemic drug-laser-photon therapy treatment.

Between January 1, 2018, and December 31, 2020, a retrospective, randomized, investigator-blinded study involving 75 patients with mixed type melasma was examined. VISIA was used to take uniform pictures during each visit. Two dermatologists scored the modified melasma area and severity index (mMASI) using pictures. Each visit included a note of any potential issues and side effects, including erythema, edema, burning, petechiae, acute urticaria, post-inflammatory hypopigmentation, and hyperpigmentation.

Key findings of the study:

• Immediately following the treatment, the mMASI score drastically dropped from 6.92 to 3.84.
• The VISIA analysis of the right cheek data reveals statistically significant increases in spots (from 49.67 3.43 to 56.09 3.31), UV spots (from 41.39 24.45 to 44.56 25.86), and brown spots (from 23.97 17.89 to 28.16 21.28) (p = 0.035, 0.018, and 0.07, respectively).
• Approximately 10.17% of patients reported being much better, 30.51% reported feeling significantly better (51%-75%), 45.76% reported feeling moderately better (26%-50%), and 13.56% reported feeling little better (1%-25%).

The authors' conclusion was that many combination therapies—including oral TA combined with 1064-nm QS-Nd: YAG laser, 1064 mixed with IPL, 20 and the combination of the three—emerged one after another based on the notion that monotherapy is less beneficial than combination with other therapies.

It has the potential to develop into a new, credible, and broadly useful therapeutic approach, they added.

REFERENCE

Li, Y, Shao, W-N, Fang, Q-Q, et al. A combination treatment of drug-laser-photon for melasma: A retrospective study of clinical cases. J Cosmet Dermatol. 2022; 00: 1- 9. doi: 10.1111/jocd.15488