Fractional erbium-doped yttrium aluminum garnet laser-assisted drug delivery of hydroquinone in the treatment of melasma

• Main Authors: Badawi AM (Author), Osman MA (Author)
• Format: Book
• Published: Dove Medical Press, 2018-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 1178-7015
• Keywords: Fractional Er:YAG laser; hydroquinone; laser - assisted drug delivery; melasma; Dermatology; RL1-803
• Source: Clinical, Cosmetic and Investigational Dermatology, Vol Volume 11, Pp 13-20 (2018)

Ashraf M Badawi,1&ndash;4 Mai Abdelraouf Osman1 1Dermatology Unit, Department of Medical Applications of Lasers (MAL), National Institute of Laser Enhanced Sciences (N.I.L.E.S.), Cairo University, Giza, Egypt; 2Dermatology and Laser Applications, Szeged University, Szeged, Hungary; 3European Society for Lasers and Energy Based Devices, Strasbourg, France; 4European Society for Cosmetic and Aesthetic Dermatology, Paris, France Background: Melasma is a difficult-to-treat hyperpigmentary disorder. Ablative fractional laser (AFL)-assisted delivery of topically applied drugs to varied targets in the skin has been an area of ongoing study and research.Objective: The objective of this study was to evaluate the efficacy and safety of fractional erbium-doped yttrium aluminum garnet (Er:YAG) laser as an assisted drug delivery for enhancing topical hydroquinone (HQ) permeation into the skin of melasma patients.Patients and methods: Thirty female patients with bilateral melasma were randomly treated in a split-face controlled manner with a fractional Er:YAG laser followed by 4% HQ cream on one side and 4% HQ cream alone on the other side. All patients received six laser sessions with a 2-week interval. The efficacy of treatments was determined through photographs, dermoscopic photomicrographs and Melasma Area Severity Index (MASI) score, all performed at baseline and at 12&nbsp;weeks of starting therapy. The patient&rsquo;s level of satisfaction was also recorded.Results: Er:YAG laser + HQ showed significantly better results (p<0.005) with regard to decrease in the degree of pigmentation as assessed on the 4-point scale than HQ alone. There was a significant decrease in MASI scores on Er:YAG laser + HQ side vs HQ side. Minor reversible side effects were observed on both sides.Conclusion: AFL-assisted delivery of HQ is a safe and effective method for the treatment of melasma. Keywords: MASI score, dermoscopy, physician global assessment