Combined use of intense pulsed light and Q-switched ruby laser for complex dyspigmentation among Asian patients.
BACKGROUND
Dyspigmentation is a common cosmetic concern among Asians. Many individuals exhibit mixed pigmentary entities including melasma, flat/small seborrheic keratoses, ephelides, solar lentigines and acquired bilateral nevus-of-Ota-like macules (ABNOM). We term this phenomenon complex dyspigmentation (CD) and suggest that a combination strategy may be more efficacious than any singular modality.


OBJECTIVE
To determine the effectiveness of combined intense-pulsed light (IPL) for global photorejuvenation along with Q-switched ruby laser (QSRL) for targeted pigment dissolution.


METHODS
Twenty-five Korean women with CD (defined as >2 types of facial pigmentary disorders) were initially treated with IPL followed by repeat treatments every 3-4 weeks as needed. The QSRL treatments, set at low fluence, were added either during the same session or within 1 week of the IPL treatment. Improvement was assessed by the patient, the treating physician and a blinded evaluation of pre- and post-treatment photographs.


RESULTS
Using a 4-point scale (1 = poor, 2 = fair, 3 = good, 4 = excellent), 19/25 patients (76%) reporting good-to-excellent response (score "3" or "4"). Two independent physician assessment revealed that 15/25 patients (60%) showed 76-100% improvement while 19/25 patients (76%) showed at least 50% improvement. Side-effects were minimal: 3 patients had transient post-inflammatory hyperpigmentation (12%) and 1 patient (4%) had linear hypopigmentation.


CONCLUSIONS
Combination treatment with IPL and QSRL is an effective and safe treatment for CD among Asian patients.
Park
Jong Min
JM
Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Tsao
Hensin
H
Tsao
Sandy
S
D000328:Adult; D044466:Asian People; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000208:ethnology* / Q000473:pathology / Q000628:therapy*; D007723:Korea; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D010789:Phototherapy / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome