Repeated treatment protocols for melasma and acquired dermal melanocytosis.
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.
Yoshimura
Kotaro
K
Department of Plastic Surgery, University of Tokyo, School of Medicine, Tokyo, Japan. yoshimura@cosmetic-medicine.jp
Sato
Katsujiro
K
Aiba-Kojima
Emiko
E
Matsumoto
Daisuke
D
Machino
Chiaki
C
Nagase
Takashi
T
Gonda
Koichi
K
Koshima
Isao
I
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*
D000975:Antioxidants; D006873:Hydroquinones; D007641:Keratolytic Agents; D014212:Tretinoin; C031927:hydroquinone