title: Combined use of monopolar radiofrequency and transdermal drug delivery in the treatment of melasma.
abstract: BACKGROUND
  Melasma is a common acquired pigmentary disorder that has a considerable psychological impact on the patient. The recurrent and refractory nature of this condition makes it difficult for treatment.
  
  
  OBJECTIVE
  We aim to evaluate the efficacy and safety of a combined system that simultaneously uses monopolar radiofrequency (RF) and transdermal drug delivery of phytocomplex containing 1% kojic acid in the treatment of melasma.
  
  
  METHODS
  Fifty patients affected by melasma underwent 6 sessions of treatment at 1-week intervals. The outcome was evaluated before treatment (T0) and 1 month (T1) and 6 months (T2) after treatment using the Melasma Area and Severity Index score, a Mexameter, and Visioface devices for digital and ultraviolet computerized image analysis of skin color.
  
  
  RESULTS
  The image analysis showed that hyperpigmentation was significantly reduced at T1 and T2 compared with baseline. Melasma Area and Severity Index score, the average melanin score, and the average erythema values showed a significant reduction. No side effects were observed or reported.
  
  
  CONCLUSIONS
  This study describes the first report of improvement in melasma through the combined use of monopolar RF with transdermal delivery of depigmenting agents. This could be a safe, tolerable, and effective alternative tool for the treatment of melasma.
authors.affiliation: *All the authors are affiliated with the Department of Dermatology, San Gallicano Institute IRCCS, Rome, Italy.
authors.forename: Norma
authors.initials: N
authors.lastname: Cameli
authors.forename: Elva
authors.initials: E
authors.lastname: Abril
authors.forename: Maria
authors.initials: M
authors.lastname: Mariano
authors.forename: Enzo
authors.initials: E
authors.lastname: Berardesca
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy / Q000009:adverse effects; D004890:Erythema / Q000209:etiology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008548:Melanosis / Q000188:drug therapy* / Q000532:radiotherapy*; D008875:Middle Aged; D011753:Pyrones / Q000008:administration & dosage* / Q000009:adverse effects; D011846:Radio Waves / Q000009:adverse effects; D000078702:Radiofrequency Therapy; D012720:Severity of Illness Index; D062327:Skin Lightening Preparations / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D011753:Pyrones; D062327:Skin Lightening Preparations; C011890:kojic acid