SAFETY AND EFFECTIVENESS OF FRACTIONAL ERBIUM-YAG (2940NM) LASER IN THE TREATMENT OF MELASMA IN SULAIMANIA CITY

Authors

  • Kazhan A. Tofiq Department of Medicine, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

DOI:

https://doi.org/10.17656/jsmc.10260

Keywords:

Laser safety, Melasma, Fractional Laser

Abstract

Background 

Melasma is acquired pigmentary disorder, characterized by brownish symmetrical patches, mostly in the sun-exposed areas of the skin. Many treatment modalities have been used, one of the advanced technologies attempted is Lasers. 

Objectives 

To assess the safety and effectiveness of Fractional Erbium(Er) -Yag laser treatment for Melasma, in addition to, determining the demographic and clinical criteria of the study group.

Patients and Methods

Thirty (30) patients diagnosed as Melasma, were included in our study. All patients interviewed and treated by Fractional Er-Yag Laser, which ranged from 1to 4 sessions. The demographic and clinical data, degree of patients’ satisfaction, and side effects were recorded and analyzed.

Results

Out of 30 patients, included in our study, 28 were females, their mean age was 33.7 years, 17 women were housewives, parity ranged between 0-4 children, only 3 patients were outdoor workers. Twenty (66.7%) patients were married, 9 were single. Daily sun exposure was more than 4hrs in 5 patients. Illness duration ranged from 6moths to 16 (mean 5.15) years. About 60% were previously treated. Two-thirds of the cases had one or more associated conditions like polycystic ovarian disease PCOD, Anemia, thyroid diseases, or were on oral contraceptive pills OCP. Areas affected were in 50% of all the three: Centro-facial, malar and mandibular. Fitzpatrick skin type of patients was type III in 18 (60%), 11 patients were type IV, and one was type II. One or more immediate side effects reported in all 30 (100%) patients. Long term side effects like hyperpigmentation happened only in one patient. Patients’ satisfaction about laser treatment was very good in 8 (26.7%) patients, good in 12 (40%), seven patients mentioned little improvement and one patient said that laser made his condition worse. 

Conclusion

Fractional Erbium-Yag Laser in the treatment of Melasma is a safe and effective therapeutic approach.

References

Ane BM , Niwa Massaki , Sasima E, Sabrina GF, Isabella G, William G, et al ,Treatment of melasma with the 1,927-nm fractional thulium fiber laser: A retrospective analysis of 20 cases with long-term follow-up. 19 December 2012. Clinical reports. https://doi.org/10.1002/lsm.22100

Grimes PE. Melasma: etiologic and therapeutic considerations. Arch Dermatol. 1995; 131:1453–7.

Ana CH., Luciane DBM., and Hélio AM, Melasma: a clinical and epidemiological review Melasma: a clinical and epidemiological review An Bras Dermatol. 2014 Sep-Oct; 89(5): 771–782.

Chaitanya NC1, Priyanka DR, Madireddy N, Ramakrishna M, Ajay M, Ignatius AV,A Chance Occurrence or a Syndrome. J Contemp. Dent. Pract. 2018 Oct 1, 2019 (10):1254-1259.

Katsambas AD, Stratigos AJ, Lotti TM. Melasma. In: Katsambas AD, Lotti TM, editors. European handbook of dermatological treatments. 2nd ed. Berlin: Springer; 2003. pp. 336–41.

Arun Achar and Sanjay K Rathi, Melasma: A Clinico-Epidemiological study of 312 Cases 2011europepmc.org/articles/pmc3178998.

Lapeere H, Boone B, Schepper SD. Hypomelanosis and hypomelanosis. In: Wolff K, Goldsmith LA, Katz SI, editors. Dermatology in general medicine. 7th ed. New York: McGraw-Hill; 2008. p. 635.

Bryan S, Giselle P, Jason Emer, Melasma and Post Inflammatory Hyperpigmentation: Management Update and Expert Opinion. January 1, 2016, STL Volume 21 Number 1.

Trivedi MK, Yang FC, Cho BK. A review of laser and light therapy in melasma. https://doi.org/10.1016/j.ijwd.2017.01.004

Bandyopadhyay D. Topical treatment of Melasma, Indian Journal of Dermatology, (2009) Oct-Dec; 54(4): 303–309.

Rashmi S, Sanjeev A, T Salim, Anupam Das, Swapnil S, Imran Majid, et al: A Review with Consensus Recommendations by Indian Pigmentary Expert Group, Indian J Dermatol. 2017 Nov-Dec; 62(6): 585–590

Cameron KR, Richard EF. The Treatment of Melasma with Fractional Photothermolysis: A Pilot Study, Dermatol Surg. 2005 Dec; 31(12):1645–50.

Grimes PE. Melasma; Etiologic and therapeutic considerations, Dermatologic Surgery. 31(12):1645–1650, DEC 2005

Souza SR, Fischer FM, Souza JM. Sun tanning and risk of cutaneous melanoma: a literature review. Rev Saude Publica. 2004; 38:588 –598.

Halder RN, Grimes PE, Mclaurin CI, Kress MA, Kennery JA., Jr Incidence of common dermatoses in a predominantly black dermatologic practice. Cutis. 1983; 32:388–90.

Sanchez NP, Pathak MA, Sato S, Fitzpatrick TB, Sanchez JL, Mihm MC Jr . Melasma: A clinical, light microscopic, ultrastructural, and immunofluorescence study. J Am Acad Dermatol. 1981; 4:698 – 710.

Pathak MA. Clinical and therapeutic aspects of Melasma: An overview. In: Fitz Patrick TB, Wick MM, Toda K, editors. Brown melanoderma. Tokyo: University of Tokyo Press; 1986. pp. 161–72.

Katasambas A, Antoniou C. Melasma: Classification and treatment. J Eur Acad Dermatol Venereol. 1995; 4: 217– 23.

Bhatt N, Alster TS. Laser surgery in dark skin. J Drugs Dermatol. 2009 Sep; 8(9):821–7.

Tian W C. Novel technique to treat melasma in Chinese: The combination of 2940-nm fractional Er: YAG and 1064-nm Q-switched Nd: YAG laser, Journal of Cosmetic and Laser Therapy, 2016.

Kauvar AN, The evolution of melasma therapy: targeting melanosomes using low-fluence Q-switched neodymium-doped yttrium aluminum garnet lasers, Seminars in Cutaneous Medicine and Surgery Journal, (2012) 31:126–132.

Manstein D., Herron G.S., Sink R.K., Tanner H., Anderson R.R. Fractional photothermolysis: A new concept for cutaneous remodeling using microscopic patterns of thermal injury, Lasers Surg Med, 34 (2004), pp. 426–438.

Published

2020-09-21

How to Cite

SAFETY AND EFFECTIVENESS OF FRACTIONAL ERBIUM-YAG (2940NM) LASER IN THE TREATMENT OF MELASMA IN SULAIMANIA CITY. (2020). JOURNAL OF SULAIMANI MEDICAL COLLEGE, 10(2), 211-220. https://doi.org/10.17656/jsmc.10260