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Triple Topical Therapy Verified as Gold Standard for Melasma

Non-ablative 1,550 nm fractional laser tied to more hyperpigmentation, lower patient satisfaction

FRIDAY, Sept. 3 (HealthDay News) -- Compared with triple topical therapy (TTT), non-ablative 1,550 nm fractional laser therapy (FLT) for the treatment of melasma is associated with an increased risk of post-inflammatory hyperpigmentation and lower patient satisfaction scores, according to a study published in the September issue of Lasers in Surgery and Medicine.

In a randomized, controlled, observer-blinded study with split-face design, Bas S. Wind, M.D., of the University of Amsterdam in the Netherlands, and colleagues evaluated the efficacy and safety of FLT as compared to TTT in 29 patients with melasma.

The investigators found that the mean patient's global assessment (PGA) and patient satisfaction were significantly lower on the FLT side compared to the TTT side. The FLT side showed a significant worsening of hyperpigmentation, as measured by a melanin index, lightness, and physician's global assessment, with no significant change observed on the TTT side. Adverse events associated with both FLT and TTT included erythema and burning sensation. Other side effects linked to FLT included edema and pain, while scaling was also associated with TTT. Overall, most patients preferred TTT at the six-month follow-up.

"Given the high rate of post-inflammatory hyperpigmentation, non-ablative 1,550 nm fractional laser at 15 mJ/microbeam is not recommendable in the treatment of melasma. TTT remains the gold standard treatment," the authors write.

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