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Abstract：
BACKGROUND: Recent evidence suggests melasma to be a photoaging disorder. Triple combination creams (TCC: fluocinolone acetonide 0.01%, hydroquinone 4% and tretinoin 0.05%) remain the gold standard treatment. Picosecond alexandrite laser treatment using a diffractive lens array (DLA) has been identified to be effective for improving photoaging conditions.
OBJECTIVE: We aimed to compare the efficacy and tolerance of the picosecond alexandrite laser with those of DLA and TCC in female Asian patients with melasma.
METHODS: Twenty-nine patients were randomly assigned to group A1 (3 laser sessions at 4-week intervals), A2 (5 laser sessions at 4-week intervals) or B (TCC daily for at least 8 weeks and then tapered until the final evaluation). The Melasma Area, Severity Index (MASI) score and VISIA were assessed at baseline, week 12 and week 20. By week 20, the follow-up periods for groups A1 and A2 were 3 months and 1 month, respectively.
RESULTS: Nine, 11 and 6 participants in groups A1, A2 and B completed the study, respectively. MASI scores were significantly improved in all 3 groups at weeks 12 and 20. In groups A1, A2 and B, the improvement rates at week 20 were 53%, 38% and 50%, respectively. VISIA® analysis additionally revealed a significant improvement in spots, porphyria, pores and brown spots after 3 laser sessions (P < 0.05). Group A2 showed greater improvements than group A1 in terms of spots, wrinkles and pores; however, only red areas were significantly different (P < 0.001). All side-effects in the 3 groups were transient and gradually subsided after 1-3 months.
CONCLUSIONS: Picosecond alexandrite laser treatment using DLA showed comparable efficacy with TCC for the treatment of melasma. Improvements in texture, spots, wrinkles and pores were observed in the laser groups. Patients with melasma lesions that exhibit telangiectasia may benefit from additional laser treatment sessions.
OBJECTIVE: We aimed to compare the efficacy and tolerance of the picosecond alexandrite laser with those of DLA and TCC in female Asian patients with melasma.
METHODS: Twenty-nine patients were randomly assigned to group A1 (3 laser sessions at 4-week intervals), A2 (5 laser sessions at 4-week intervals) or B (TCC daily for at least 8 weeks and then tapered until the final evaluation). The Melasma Area, Severity Index (MASI) score and VISIA were assessed at baseline, week 12 and week 20. By week 20, the follow-up periods for groups A1 and A2 were 3 months and 1 month, respectively.
RESULTS: Nine, 11 and 6 participants in groups A1, A2 and B completed the study, respectively. MASI scores were significantly improved in all 3 groups at weeks 12 and 20. In groups A1, A2 and B, the improvement rates at week 20 were 53%, 38% and 50%, respectively. VISIA® analysis additionally revealed a significant improvement in spots, porphyria, pores and brown spots after 3 laser sessions (P < 0.05). Group A2 showed greater improvements than group A1 in terms of spots, wrinkles and pores; however, only red areas were significantly different (P < 0.001). All side-effects in the 3 groups were transient and gradually subsided after 1-3 months.
CONCLUSIONS: Picosecond alexandrite laser treatment using DLA showed comparable efficacy with TCC for the treatment of melasma. Improvements in texture, spots, wrinkles and pores were observed in the laser groups. Patients with melasma lesions that exhibit telangiectasia may benefit from additional laser treatment sessions.
摘要：
背景：最近的证据表明黄褐斑是一种光老化障碍。三重组合霜（TCC：氟轻松度0.01％，氢醌4%和维甲酸0.05%)仍然是黄金标准治疗。已确定使用衍射透镜阵列（DLA）的皮秒翠绿宝石激光治疗可有效改善光老化条件。
目的：我们旨在比较皮秒翠绿宝石激光与DLA和TCC在亚洲女性黄褐斑患者中的疗效和耐受性。
方法：29例患者被随机分配到A1组（3次激光治疗，间隔4周），A2（5次激光疗程，间隔4周）或B（TCC每天至少8周，然后逐渐减少，直到最终评估）。黄褐斑区,在基线时评估严重指数（MASI）评分和VISIA，第12周和第20周。到第20周，A1和A2组的随访时间分别为3个月和1个月。分别。
结果：9，A1，A2和B组中的11名和6名参与者完成了研究，分别。在第12周和第20周，所有3组的MASI评分均显着提高。A1、A2和B组,第20周的改善率为53%，38%和50%，分别。VISIA®分析还显示了斑点的显着改善，卟啉症,3次激光后的毛孔和褐色斑点（P<0.05）。A2组在斑点方面比A1组表现出更大的改善，皱纹和毛孔；然而，只有红色区域有显著差异(P<0.001)。3组的所有副作用均为一过性，并在1-3个月后逐渐消退。
结论：使用DLA的皮秒紫翠石激光治疗黄褐斑的疗效与TCC相当。改善纹理，斑点,在激光组中观察到皱纹和毛孔。表现出毛细血管扩张的黄褐斑病变患者可能会从额外的激光治疗中受益。
目的：我们旨在比较皮秒翠绿宝石激光与DLA和TCC在亚洲女性黄褐斑患者中的疗效和耐受性。
方法：29例患者被随机分配到A1组（3次激光治疗，间隔4周），A2（5次激光疗程，间隔4周）或B（TCC每天至少8周，然后逐渐减少，直到最终评估）。黄褐斑区,在基线时评估严重指数（MASI）评分和VISIA，第12周和第20周。到第20周，A1和A2组的随访时间分别为3个月和1个月。分别。
结果：9，A1，A2和B组中的11名和6名参与者完成了研究，分别。在第12周和第20周，所有3组的MASI评分均显着提高。A1、A2和B组,第20周的改善率为53%，38%和50%，分别。VISIA®分析还显示了斑点的显着改善，卟啉症,3次激光后的毛孔和褐色斑点（P<0.05）。A2组在斑点方面比A1组表现出更大的改善，皱纹和毛孔；然而，只有红色区域有显著差异(P<0.001)。3组的所有副作用均为一过性，并在1-3个月后逐渐消退。
结论：使用DLA的皮秒紫翠石激光治疗黄褐斑的疗效与TCC相当。改善纹理，斑点,在激光组中观察到皱纹和毛孔。表现出毛细血管扩张的黄褐斑病变患者可能会从额外的激光治疗中受益。
