New combination laser therapies may improve treatment for mixed-type melasma, according to the American Academy of Dermatology.

Melasma is typically controlled with topical medications that contain ingredients to lighten the skin such as hydroquinone or retinoids along with regular use of broad-spectrum sunscreen with a Sun Protection Factor (SPF) of 30. However, this therapy may only provide temporary improvement in more difficult cases, says dermatologist Arielle N.B. Kauvar, MD, a clinical professor of dermatology at New York University School of Medicine in New York City, in a press release.

“Effective treatment of mixed-type melasma requires a very low-energy and low-impact procedure because irritation and inflammation can worsen melasma,” says Dr. Kauvar. “Based on these requirements, I combined microdermabrasion, low-energy laser and a pigment-suppressing skin care regimen, which has shown to be painless, non-invasive, safe on any skin type and requires no downtime.”

With the new combination therapy, dermatologists perform a microdermabrasion immediately followed by a low-energy laser treatment with a Q-switched YAG laser. Patients then begin a topical regimen using hydroquinone and sunscreen. “While this treatment uses a very low laser energy, it’s high enough to break up the pigment without heating the skin,” says Dr. Kauvar.

In a study by Dr. Kauvar of 27 women with mixed-type melasma, 22 subjects showed greater than 75% improvement of their melasma after an average of 2.6 laser treatments. Of those, 11 achieved more than 95% improvement of their melasma. In addition, clearance of melasma was maintained for at least 6 months.

Source: American Academy of Dermatology