“While this treatment uses a very low laser energy, it’s high enough to break up the pigment without heating the skin,” said Dr. Kauvar. “Melasma is a chronic disease, like psoriasis or eczema, which can be controlled but not cured. So far, we have been able to control melasma more effectively and extend the remission periods. I also find that patients are more motivated to continue their recommended skin care regimen to further help control flares.”
Tattoos Getting the Boot with New Laser Therapies
While lasers have been used to remove tattoos for several years, the procedure requires multiple treatment sessions (typically six to 10 treatments or more) and treatments are painful, requiring a few weeks of healing time between procedures. Dr. Kauvar noted that the process of tattoo ink removal is inefficient since every color of ink absorbs different wavelengths of light, requiring the use of multiple lasers. Some colors – such as yellow, orange, turquoise or fluorescent ones – remain more difficult to treat.
“Unfortunately, there is no ideal laser to remove all tattoo colors, but new approaches have recently been introduced that appear to produce better results with fewer treatment sessions,” said Dr. Kauvar.
One new study uses the Q-switched YAG laser to treat a tattoo four times in one day. These four separate treatments are administered at 20-minute intervals and have demonstrated much faster clearance of tattoo inks. Other research involves the use of the fractional ablative laser in conjunction with traditional tattoo-removal lasers to speed up clearance – resulting in as much as 50 percent tattoo ink removal in just one treatment session. In another new study, Dr. Kauvar is investigating the effectiveness of administering two treatments in one day using a combination of laser wavelengths to target different ink colors. With this procedure, Dr. Kauvar first uses a Q-switched YAG laser on the tattoo, followed by a Q-switched alexandrite laser (which is better at treating blues and greens) 20 minutes after the first laser. Dr. Kauvar noted that initial results of this procedure have shown significant improvement in removing blue, green and black inks.
Over the years, various treatments developed to treat melasma including
Chemical peels. The most commonly used acid compounds to remove melasma include trichloroacetic acid, azelaic acid, glycolic acid, lactic acid and various fruit extracts. Stronger peeling agents tend to have a higher effectiveness rate than lighter strength peeling agents. Stronger peeling agents may also carry the risk of side effects such as burning, skin peeling, scarring and even worsening the skin discoloration.
Skin lightening agents. There are many skin lightening agents on the market and the most commonly used is hydroquinone. Numerous other agents sold in herbal and nutrition stores may work as skin lightening agents as well, however each patient has a unique skin type and reactions to skin lightening agents vary.
Sunscreens, especially those which are mineral based, such as zinc and titanium.
Laser skin rejuvenation
These treatments do not necessarily cure the cause of melasma and the effectiveness of each will vary from patient to patient. Even after treatment, skin discoloration may not always disappear completely and each patient may have to try various different treatment options to see a satisfactory result. Some treatments may have to be continually performed to sustain results, such as applying a skin lightening agent on a regular basis, combined with effective sunscreen usage and sun exposure avoidance.
To help prevent melasma from worsening, patients may wear sunscreen which contains a mineral based shield from the sun with an SPF at least 20. Protective clothing and wearing a hat may help to prevent melasma from worsening. Protective facial make-up may also be worn to help even skin tone and block out the sun.
“The biggest drawbacks to laser tattoo removal are the time, expense, pain and healing involved,” said Dr. Kauvar. “The newest techniques being investigated are designed to reduce the number of treatment sessions required to remove a tattoo, which should make the process more appealing.”
Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 17,000 physicians worldwide, the Academy is committed to - advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or http://www.aad.org. Follow the Academy on Facebook (American Academy of Dermatology) or Twitter (@AADskin).
Academy of Dermatology (AAD)