title: Treatment of melasma with the 1,927-nm fractional thulium fiber laser: a retrospective analysis of 20 cases with long-term follow-up.
abstract: BACKGROUND
  Melasma is a common acquired symmetrical hyperpigmentation that is often recurrent and refractory.
  
  
  OBJECTIVE
  To investigate the efficacy and safety of a single administration of high-density fractional thulium fiber laser (1,927 nm) for the treatment of refractory melasma in 20 patients.
  
  
  METHODS
  A retrospective chart and photographs review of 20 women (Fitzpatrick skin type II-IV) with clinical diagnosis of melasma treated with the 1,927-nm fractionated thulium laser at 10 or 20 mJ/cm(2) , with 60-70% surface area coverage. Four investigators independently evaluated Melasma Area Severity Index (MASI) scores before, 4 weeks, 3-6 months, and 6-12 months after treatment.
  
  
  RESULTS
  Mean MASI scores decreased dramatically from 13.2 ± 5.4 before treatment to 8.5 ± 3.5 at 4 weeks after laser treatment (P = 0.004). Patient assessment revealed that 12 of the 20 subjects had more than 50% clearance of their melasma. Recurrence was reported by 7 out of 15 patients who were successfully followed-up (mean 10.2 months). Two patients developed postinflammatory hyperpigmentation that subsided with topical bleaching after 3 months.
  
  
  CONCLUSIONS
  High-density coverage fractional 1,927-nm thulium laser proved to be safe and effective for melasma with long-term remission.
authors.affiliation: Goldman, Butterwick, Fitzpatrick, Groff and Fabi Cosmetic Laser Dermatology, 8232 Regents Rd, Apt 201, San Diego, CA 92122, USA. aneniwa@gmail.com
authors.forename: Ane Beatriz M
authors.initials: AB
authors.lastname: Niwa Massaki
authors.forename: Sasima
authors.initials: S
authors.lastname: Eimpunth
authors.forename: Sabrina G
authors.initials: SG
authors.lastname: Fabi
authors.forename: Isabella
authors.initials: I
authors.lastname: Guiha
authors.forename: William
authors.initials: W
authors.lastname: Groff
authors.forename: Richard
authors.initials: R
authors.lastname: Fitzpatrick
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008548:Melanosis / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome