title: Combined vitamin C sonophoresis and neodymium-doped yttrium aluminum garnet (NdYAG) laser for facial hyperpigmentation: An outcome observation study in Asian patients.
abstract: BACKGROUND
  The neodymium-doped yttrium aluminum garnet (NdYAG) laser therapy has been a popular technique for facial rejuvenation but certain adverse effects like post-inflammatory hyperpigmentation are issues of concern to Asian patients.
  
  
  OBJECTIVE
  To assess the outcome following combined treatment with vitamin C sonophoresis and NdYAG laser, in selected cases of facial hyperpigmentation.
  
  
  METHODS
  Twenty three women with dyschromia or melasma who had undergone five sessions of Q-switched NdYAG laser therapy followed by transdermal delivery of vitamin C via sonophoresis were selected after a retrospective review of case records. The objective and subjective clinical outcomes and the side effects, including erythema, scaling, pruritus, dryness and post-inflammatory hyperpigmentation were evaluated.
  
  
  RESULTS
  In both objective or subjective outcomes, 91.3% (21/23) of the patients showed an excellent or better outcome, while 8.7% (2/23) showed no change. A majority of the patients (73.9%, 17/23) experienced no post-inflammatory hyperpigmentation or had slight post-inflammatory hyperpigmentation which quickly resolved within 1 week. Only one (4.3%) patient had extreme post-inflammatory hyperpigmentation which lasted for over a month.
  
  
  CONCLUSIONS
  This was a retrospective study without a control group; a comparative study with a control group (patients treated with the laser alone, without vitamin C sonopheresis) is needed to determine the difference in the outcome.
  
  
  CONCLUSIONS
  The use of vitamin C sonophoresis along with NdYAG laser may reduce the incidence of adverse effects in Asian patients. Patients experienced obvious improvement in hyperpigmentation and had lower chances of experiencing extreme or severe post-inflammatory hyperpigmentation.
authors.affiliation: Department of Dermatology, Shuang Ho Hospital, Taipei Medical University; School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan, ROC.
authors.forename: Yu-Tsung
authors.initials: YT
authors.lastname: Chen
authors.affiliation: Department of Plastic Surgery, Chiayi Chang Gung Memorial Hospital, Puzi; School of Medicine, China Medical University, Taichung, Taiwan; Institute of Imaging and Biomedical Photonics, National Chiao Tung University, Taiwan, ROC.
authors.forename: Chang-Cheng
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Department of Ophthalmology, Tri-Service General Hospital, Taipei, Taiwan, ROC.
authors.forename: Cherng-Ru
authors.initials: CR
authors.lastname: Hsu
authors.affiliation: Department of Ophthalmology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.
authors.forename: Jen-Hsiang
authors.initials: JH
authors.lastname: Shen
authors.affiliation: Department of Dermatology, Chiayi Chang Gung Memorial Hospital, Puzi, Taiwan, ROC.
authors.forename: Chao-Jen
authors.initials: CJ
authors.lastname: Shih
authors.affiliation: Institute of Imaging and Biomedical Photonics, National Chiao Tung University; Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan, ROC.
authors.forename: Bor-Shyh
authors.initials: BS
authors.lastname: Lin
mesh_terms: D000328:Adult; D000535:Aluminum / Q000008:administration & dosage*; D001205:Ascorbic Acid / Q000008:administration & dosage*; D044466:Asian People; D005145:Face / Q000473:pathology / Q000528:radiation effects; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000175:diagnosis / Q000532:radiotherapy*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D028022:Low-Level Light Therapy / Q000379:methods*; D008875:Middle Aged; D009354:Neodymium / Q000008:administration & dosage*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult; D015019:Yttrium / Q000008:administration & dosage*
chemical_list: C503779:yttrium-aluminum-garnet; D009354:Neodymium; D015019:Yttrium; D000535:Aluminum; D001205:Ascorbic Acid