title: Repeated treatment protocols for melasma and acquired dermal melanocytosis.
abstract: OBJECTIVE
  Melasma and acquired dermal melanocytosis (ADM; acquired bilateral nevus of Ota-like macules) are both seen most commonly symmetrically on the face of women with darker skin and are also known as difficult conditions to treat.
  
  
  METHODS
  Our topical bleaching protocol with 0.1 to 0.4% tretinoin gel and 5% hydroquinone was performed repeatedly (1-3 times) for melasma (n=163), and a combination treatment with topical bleaching and Q-switched ruby (QSR) laser was performed repeatedly (1-3 times) for ADM (n=62).
  
  
  RESULTS
  There is a significant correlation between clinical results (clearance of pigmentation) and the number of sessions in both melasma (p=.019) and ADM (p<.0001).
  
  
  CONCLUSIONS
  The repeated treatment protocol for melasma and ADM showed successful clinical results compared with conventional ones, and they may be applied to other pigment conditions. It may be better that epidermal and dermal pigmentations are treated separately, especially in dark-skinned people who are more likely to suffer postinflammatory hyperpigmentation after inflammation-inducing therapies.
authors.affiliation: Department of Plastic Surgery, University of Tokyo, School of Medicine, Tokyo, Japan. yoshimura@cosmetic-medicine.jp
authors.forename: Kotaro
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Katsujiro
authors.initials: K
authors.lastname: Sato
authors.forename: Emiko
authors.initials: E
authors.lastname: Aiba-Kojima
authors.forename: Daisuke
authors.initials: D
authors.lastname: Matsumoto
authors.forename: Chiaki
authors.initials: C
authors.lastname: Machino
authors.forename: Takashi
authors.initials: T
authors.lastname: Nagase
authors.forename: Koichi
authors.initials: K
authors.lastname: Gonda
authors.forename: Isao
authors.initials: I
authors.lastname: Koshima
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000008:administration & dosage; D044466:Asian People; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005153:Facial Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006873:Hydroquinones / Q000008:administration & dosage; D007641:Keratolytic Agents / Q000008:administration & dosage*; D028022:Low-Level Light Therapy; D008297:Male; D008548:Melanosis / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000473:pathology / Q000628:therapy*; D019233:Retreatment; D012878:Skin Neoplasms / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage*
chemical_list: D000975:Antioxidants; D006873:Hydroquinones; D007641:Keratolytic Agents; D014212:Tretinoin; C031927:hydroquinone