Abstract
Melasma is a common and persistent disorder of hyperpigmentation that affects a significant portion of the population, affecting mainly women. It is often a therapeutically challenging disorder. Physical therapies such as chemical peels, dermabrasion, lasers, and intense pulsed light have also been used with varying degrees of success and side effects. Dark circles eyes, also known as periorbital hyperpigmentation, are a common condition that occurs in both sexes with an increasing frequency in females. Aesthetic treatments include microdermabrasion, chemical peels, lasers, radiofrequency, injectable fillers, surgery, fat transfer, and lightening topical products. Clinical signs of photoaging include coarse skin texture, irregular pigmentation, and laxity of skin tone, as well as the appearance of fine lines and wrinkles. Diverse treatment modalities have been used to improve skin wrinkling and laxity, including chemical peeling, soft tissue filler, laser ablation, and facelift surgery. Lasers have revolutionized the treatment of many dermatological conditions. Different types of lasers can be indicated for pigmentary disorders. Recently, Q-switched lasers arose as a successful application in melasma, dark circles eyes, and photorejuvenation due to its low fluence, short pulse, and specific wavelength.
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References
Alsaad SM, Ross EV, Mishra V, Miller L. A split face study to document the safety and efficacy of clearance of melasma with a 5 ns Q-switched Nd:YAG laser versus a 50 ns Q-switched Nd:YAG laser. Lasers Srug Med. 2014;10:736–40.
Anderson RR, Parrish JA. Selective photothermolysis. Precise microsurgery by selective absorption of pulsed radiation. Science. 1983;220:524–7.
Anderson RR, Margolis RJ, Watanabe S, et al. Selective photothermolysis of cutaneous pigmentation by Q-switched Nd:YAG laser pulses at 1064, 532, and 355 nm. J Invest Dermatol. 1989;93:28–32.
Arora P, Sarkar R, Garg V, Arya L. Lasers for treatment of melasma and post-inflammatory hyperpigmentation. J Cutan Aesthet Surg. 2012;5(2):93–103.
Balkrishnan R, McMichael AJ, Camacho FT, et al. Development and validation of a health-related quality of life instrument for women with melasma. Br J Dermatol. 2003;149:572–7.
Brown AS, Hussain M, Goldberg DJ. Treatment of melasma with low fluence, large spot size, 1064-nm Q-switched neodymium-doped yttrium aluminium garnet) Nd:YAG laser for the treatment of melasma in Fitzpatrick skin types II-IV. J Cosmet Laser Ther. 2011;13:280–2.
Chan NP, Ho SG, Shek SY, Yeung CK, Chan HH. A case series of facial depigmentation associated with low fluence Q-switched 1,064 nm Nd:YAG laser for skin rejuvenation and melasma. Lasers Surg Med. 2010;42:712–9.
Choi M, Choi JW, Lee SY, et al. Low-dose 1064-nm Q-switched Nd:YAG laser for the treatment of melasma. J Dermatolog Treat. 2010;21(4):224–8.
Dominguez AR, Balkrishnan R, Ellzey AR, et al. Melasma in Latina patients: cross-cultural adaptation and validation of a quality-of-life questionnaire in Spanish language. J Am Acad Dermatol. 2006;55:59–66.
Dover J, Arndt K, Metelitsa A, et al. Picosecond 755 nm alexandrite laser for treatment of tattoos and benign pigmented lesions: a prospective trial. Lasers Surg Med. 2012;44:6.
Freitag FM, Cestari TF. What causes dark circles under the eyes? J Cosmet Dermatol. 2007;6:211–5.
Friedmann DP, Goldman MP. Dark circles: etiology and management options. Clin Plast Surg. 2015;42(1):33–50.
Goldberg DJ. Laser treatment of pigmented lesions. Dermatol Clin. 1997;15:397–406.
Goldberg DJ, Silapunt S. Histologic evaluation of a Q-switched Nd:YAG laser in the nonablative treatment of wrinkles. Dermatol Surg. 2001;27:744–6.
Grimes PE. Melasma. Etiologic and therapeutic considerations. Arch Dermatol. 1995;131(12):1453–7.
Gupta AK, Gover MD, Nouri K, et al. The treatment of melasma: a review of clinical trials. J Am Acad Dermatol. 2006;55:1048–65.
Hilton S, Heise H, Buhren BA, Schrumpf H, Bolke E, Gerber PA. Treatment of melasma in Caucasian patients using a novel 694-nm Q-switched ruby fractional laser. Eur J Med Res. 2013;18:43.
Hong JS, Park SY, Seo KK et al. (2014). Long pulsed 1064 nm Nd:YAG laser treatment for wrinkle reduction and skin laxity: evaluation of new parameters. Int J Dermatol. 16 Dec.
Jalaly NY, Valizadeh N, Barikbin B, Yousefi M. Low-power fractional CO2 laser versus low-fluence Q-switch 1064 nm Nd:YAG laser for treatment of melasma: a ramdomized, controlled, split-face study. Am J Clin Dermatol. 2014;15(4):357–63.
Jang WS, Lee CK, Kim BJ, et al. Efficacy of 694-nm Q-switched ruby fractional laser treatment of melasma in female Korean patients. Dermatol Surg. 2011;37(8):1133–40.
Jesitus J (2014). Melasma may require aggressive combination therapy. Dermatol Times. 11 Aug.
Kang HY, Kim JH, Goo BC. The dual toning technique for melasma treatment with the 1064 nm Nd:YAG laser: a preliminary study. Laser Ther. 2011;20(3):189–94.
Katsambas A, Antoniou CH. Melasma. Classification and treatment. J Eur Acad Dermatol Venereol. 1995;4:217–23.
Kauvar AN. Successful treatment of melasma using a combination of microdermabrasion and Q-switched Nd:YAG lasers. Lasers Surg Med. 2012;44(2):117–24.
Kim EH, Kim YC, Lee ES, Kang HY. The vascular characteristics of melasma. J Dermatol Sci. 2007;46:111–6.
Kim MJ, Kim JS, Cho SB. Punctate leucoderma after melasma treatment using 1064-nm Q-switched Nd:YAG laser with low pulse energy. J Eur Acad Dermatol Venereol. 2009;23(8):960–2.
Kim T, Cho SB, Oh SH. Punctate leucoderma after 1,064-nm Q-switched neodymium-doped yttrium aluminum garnet laser with low-fluence therapy: is it melanocytopenic or melanopenic? Dermatol Surg. 2010;36(11):1790–1.
Kopera D, Hohenleutner U, Landthaler M. Quality-switched ruby laser treatment of solar lentigines and Becker’s nevus: a histopathological and immunohistochemical study. Dermatology. 1997;194:338–43.
Lee MW. Combination 532-nm and 1064-nm lasers for noninvasive skin rejuvenation and toning. Arch Dermatol. 2003;139:1265–76.
Lee HI, Lim YY, Kim BJ, et al. Clinical pathologic efficacy of copper bromide plus/yellow laser (578nm with 511nm) for treatment of melasma in Asian patients. Dermatol Surg. 2010;36:885–93.
Mun JY, Jeong SY, Kim JH, et al. A low fluence Q-switched Nd:YAG laser modifies the 3D structure of melanocyte and ultrastructure of melanosome by subcellular-selective photothermolysis. J Electron Microsc (Tokyo). 2011;60(1):11–8.
Nelson JS, Applebaum J. Treatment of superficial cutaneous pigmented lesions by melanin-specific selective photothermolysis using the Q-switched ruby laser. Ann Plast Surg. 1992;29(3):231–7.
Park JM, Tsao H, Tsao S. Combined use of intense pulsed light and Q-switched ruby laser for complex dyspigmentation among Asian patients. Lasers Surg Med. 2008;40(2):128–33.
Park KY, Kim DH, Kim HK, et al. A randomized, observer-blinded, comparison of combined 1064-nm Q-switched neodymium-doped yttrium-aluminium-garnet laser plus 30% glycolic acid peel vs. laser monotherapy to treat melasma. Clin Exp Dermatol. 2011;36(8):864–70.
Polder KD, Landau JM, Vergilis-Kalner IJ, et al. Laser eradication of pigmented lesions: a review. Dermatol Surg. 2011;37(5):572–95.
Polnikorn N (2011). Treatment of melasma, hyperpigmentation, rejuvenation and acne with revlite. Whitepaper.
Rigopoulos D, Gregeoriou S, Katsmabas A. Hyperpigmentation and melasma. J Cosmet Dermatol. 2007;6:195–202.
Roberts WE. Periorbital hyperpigmentation: review of etiology, medical evaluation, and aesthetic treatment. J Drugs Dermatol. 2014;13(4):472–82.
Roh MR, Chung KY. Infraorbital dark circles: definition, causes, and treatment options. Dermatol Surg. 2009;35:1163–71.
Sarkar R, Arora P, Garg VK, Sonthalia S, Gokhale N. Melasma update. Indian Dermatol Online. 2014;5(4):426–35.
Schmults CD, Phelps R, Goldberg DJ. Nonablative facial remodeling, erythema reduction and histologic evidence of new collagen formation using a 300-microsecond 1064-nm Nd:YAG laser. Arch Dermatol. 2004;140:1373–6.
Se-Yeong J, Sung-Eun C, Jae-Bin S, H-Na P, Jee-Ho C, Il-Hwan K. New melasma treatment by collimated low fluence Q-Switched Nd:YAG laser. HYPERLINK “http://www.lutronic.com” www.lutronic.com 2008.
Sim JH, Park YL, Lee JS, Lee SY, Choi WB, Kim HJ, Lee JH. Treatment os melasma by low-fluence 1064 nm Q-switched Nd:YAG laser. J Dermatol Treat. 2014;25(3):212–7.
Stratigos AJ, Dover JS, Arndt KA. Laser treatment of pigmented lesions – 2000. How far have we gone? Arch Dermatol. 2000;136:915–21.
Suh KS, Sung JY, Roh HJ, Jeon YS, Kim YC, Kim ST. Efficacy of the 1064 nm Q-switched Nd:YAG laser in melasma. J Dermatol Treat. 2011;22(4):233–8.
Taylor CR, Anderson RR. Treatment of benign pigmented epidermal lesions by Q-switched ruby laser. Int J Dermatol. 1993;32:908–12.
Taylor CR, Anderson RR. Ineffective treatment of refractory melasma and postinflammatory hyperpigmentation by Q-switched ruby laser. J Dermatol Surg Oncol. 1994;20:592–7.
Wang CC, Chen CK. Effect of spot size and fluence on Q-switched alexandrite laser treatment for pigmentation in Asians: a randomized, double-blinded, split-face comparative trial. J Dermatolog Treat. 2012;23:333–8.
Wattanakrai P, Mornchan R, Eimpunth S. Low-fluence Q-switched neodymium-doped yttrium aluminum garnet (1,064 nm) laser for the treatment of facial melasma in Asians. Dermatol Surg. 2010;36(1):76–87.
Werlinger KD, Guevara IL, Gonzalez CM, et al. Prevalence of self-diagnosed melasma among premenopausal Latino women in Dallas and for worth, tex. Arch Dermatol. 2007;143:424–5.
Xu TH, Yang ZH, Li YH, et al. Treatment of infraorbital dark circles using a low-fluence Q-switched 1,064-nm laser. Dermatol Surg. 2011;37(6):797–803.
Yaghmai D, Garden JM, Bakus AD, et al. Photodamage therapy using an electro-optic Q-switched Nd:YAG laser. Lasers Surg Med. 2010;42(8):699–705.
Zhou X, Gold MH, Lu Z, et al. Efficacy and safety of Q-switched 1,064-nm neodymium-doped yttrium aluminum garnet laser treatment of melasma. Dermatol Surg. 2011;37(7):962–70.
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Neiva, J., Delorenze, L.M., Issa, M.C.A. (2018). Q-Switched Lasers for Melasma, Dark Circles Eyes, and Photorejuvenation. In: Issa, M., Tamura, B. (eds) Lasers, Lights and Other Technologies. Clinical Approaches and Procedures in Cosmetic Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-16799-2_8
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