Prospective randomized controlled trial comparing treatment efficacy and tolerance of picosecond alexandrite laser with a diffractive lens array and triple combination cream in female asian patients with melasma
Background Recent evidence suggests melasma to be a photoaging disorder. Triple combination creams (TCC: fluocinolone acetonide 0.01%, hydroquinone 4% and tretinoin 0.05%) remain the gold standard treatment. Picosecond alexandrite laser treatment using a diffractive lens array (DLA) has been identif...
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| Veröffentlicht in: | Journal of the European Academy of Dermatology and Venereology 2020-03, Vol.34 (3), p.624-632 |
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| container_title | Journal of the European Academy of Dermatology and Venereology |
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| creator | Wang, Y.‐J. Lin, E.‐T. Chen, Y.‐T. Chiu, P.‐C. Lin, B.‐S. Chiang, H.‐M. Huang, Y.‐H. Wang, K.‐Y. Lin, H.‐Y. Chang, T.‐M. Chang, C.‐C. |
| description | Background
Recent evidence suggests melasma to be a photoaging disorder. Triple combination creams (TCC: fluocinolone acetonide 0.01%, hydroquinone 4% and tretinoin 0.05%) remain the gold standard treatment. Picosecond alexandrite laser treatment using a diffractive lens array (DLA) has been identified to be effective for improving photoaging conditions.
Objective
We aimed to compare the efficacy and tolerance of the picosecond alexandrite laser with those of DLA and TCC in female Asian patients with melasma.
Methods
Twenty‐nine patients were randomly assigned to group A1 (3 laser sessions at 4‐week intervals), A2 (5 laser sessions at 4‐week intervals) or B (TCC daily for at least 8 weeks and then tapered until the final evaluation). The Melasma Area, Severity Index (MASI) score and VISIA were assessed at baseline, week 12 and week 20. By week 20, the follow‐up periods for groups A1 and A2 were 3 months and 1 month, respectively.
Results
Nine, 11 and 6 participants in groups A1, A2 and B completed the study, respectively. MASI scores were significantly improved in all 3 groups at weeks 12 and 20. In groups A1, A2 and B, the improvement rates at week 20 were 53%, 38% and 50%, respectively. VISIA® analysis additionally revealed a significant improvement in spots, porphyria, pores and brown spots after 3 laser sessions (P |
| doi_str_mv | 10.1111/jdv.15934 |
| format | Article |
| fullrecord | <record><control><sourceid>wiley_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1111_jdv_15934</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>JDV15934</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3254-2fa9d9d1482cd31fe0416b7b37b2ab6e4467373c33d84864e2f2e2b704cc19c03</originalsourceid><addsrcrecordid>eNp1kcFuFSEUhonR2Gt14QuYs3UxLQzcmWFpqq2aJrpo3U7OwEFpGGYC2Hp9TV9I6lR3sgHO-fn-E37GXgp-Iuo6vbG3J2KvpXrEdkJ1QyP5IB-zHddt12i910fsWc43nHMh9sNTdiSF0kr3csd-fU5LXskUf0uQMNpl9j_JglliSUsI9ViSx1AL84rJx6_1TlhmigXIOW_QHKC-g7IEqgBDsDhYvVkyVYgFDPSj9pMvBAEzJbjz5RsgWO9cws05UMyAKeEDK_k10L3n5CMWv0Qw1XUGH8HRXJGA2WOEtTbrJHljzlQNZnzOnjgMmV487Mfs-vzd1dn75vLTxYezN5eNke1eNa1DbbUVamiNlcIRV6Kb-kn2U4tTR0p1veylkdIOaugUta6lduq5MkZow-Uxe71xTf3DnMiNa_IzpsMo-HgfzFiDGf8EU7WvNu36fZrJ_lP-TaIKTjfBnQ90-D9p_Pj2y4b8DdE6nqU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Prospective randomized controlled trial comparing treatment efficacy and tolerance of picosecond alexandrite laser with a diffractive lens array and triple combination cream in female asian patients with melasma</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Wang, Y.‐J. ; Lin, E.‐T. ; Chen, Y.‐T. ; Chiu, P.‐C. ; Lin, B.‐S. ; Chiang, H.‐M. ; Huang, Y.‐H. ; Wang, K.‐Y. ; Lin, H.‐Y. ; Chang, T.‐M. ; Chang, C.‐C.</creator><creatorcontrib>Wang, Y.‐J. ; Lin, E.‐T. ; Chen, Y.‐T. ; Chiu, P.‐C. ; Lin, B.‐S. ; Chiang, H.‐M. ; Huang, Y.‐H. ; Wang, K.‐Y. ; Lin, H.‐Y. ; Chang, T.‐M. ; Chang, C.‐C.</creatorcontrib><description>Background
Recent evidence suggests melasma to be a photoaging disorder. Triple combination creams (TCC: fluocinolone acetonide 0.01%, hydroquinone 4% and tretinoin 0.05%) remain the gold standard treatment. Picosecond alexandrite laser treatment using a diffractive lens array (DLA) has been identified to be effective for improving photoaging conditions.
Objective
We aimed to compare the efficacy and tolerance of the picosecond alexandrite laser with those of DLA and TCC in female Asian patients with melasma.
Methods
Twenty‐nine patients were randomly assigned to group A1 (3 laser sessions at 4‐week intervals), A2 (5 laser sessions at 4‐week intervals) or B (TCC daily for at least 8 weeks and then tapered until the final evaluation). The Melasma Area, Severity Index (MASI) score and VISIA were assessed at baseline, week 12 and week 20. By week 20, the follow‐up periods for groups A1 and A2 were 3 months and 1 month, respectively.
Results
Nine, 11 and 6 participants in groups A1, A2 and B completed the study, respectively. MASI scores were significantly improved in all 3 groups at weeks 12 and 20. In groups A1, A2 and B, the improvement rates at week 20 were 53%, 38% and 50%, respectively. VISIA® analysis additionally revealed a significant improvement in spots, porphyria, pores and brown spots after 3 laser sessions (P < 0.05). Group A2 showed greater improvements than group A1 in terms of spots, wrinkles and pores; however, only red areas were significantly different (P < 0.001). All side‐effects in the 3 groups were transient and gradually subsided after 1–3 months.
Conclusion
Picosecond alexandrite laser treatment using DLA showed comparable efficacy with TCC for the treatment of melasma. Improvements in texture, spots, wrinkles and pores were observed in the laser groups. Patients with melasma lesions that exhibit telangiectasia may benefit from additional laser treatment sessions.</description><identifier>ISSN: 0926-9959</identifier><identifier>EISSN: 1468-3083</identifier><identifier>DOI: 10.1111/jdv.15934</identifier><identifier>PMID: 31494973</identifier><language>eng</language><publisher>England</publisher><subject>Adult ; Asian Continental Ancestry Group ; Combined Modality Therapy ; Drug Combinations ; Female ; Fluocinolone Acetonide - administration & dosage ; Humans ; Hydroquinones - administration & dosage ; Lasers, Solid-State - therapeutic use ; Melanosis - drug therapy ; Melanosis - surgery ; Middle Aged ; Ointments ; Prospective Studies ; Single-Blind Method ; Treatment Outcome ; Tretinoin - administration & dosage</subject><ispartof>Journal of the European Academy of Dermatology and Venereology, 2020-03, Vol.34 (3), p.624-632</ispartof><rights>2019 European Academy of Dermatology and Venereology</rights><rights>2019 European Academy of Dermatology and Venereology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3254-2fa9d9d1482cd31fe0416b7b37b2ab6e4467373c33d84864e2f2e2b704cc19c03</citedby><cites>FETCH-LOGICAL-c3254-2fa9d9d1482cd31fe0416b7b37b2ab6e4467373c33d84864e2f2e2b704cc19c03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjdv.15934$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjdv.15934$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31494973$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Y.‐J.</creatorcontrib><creatorcontrib>Lin, E.‐T.</creatorcontrib><creatorcontrib>Chen, Y.‐T.</creatorcontrib><creatorcontrib>Chiu, P.‐C.</creatorcontrib><creatorcontrib>Lin, B.‐S.</creatorcontrib><creatorcontrib>Chiang, H.‐M.</creatorcontrib><creatorcontrib>Huang, Y.‐H.</creatorcontrib><creatorcontrib>Wang, K.‐Y.</creatorcontrib><creatorcontrib>Lin, H.‐Y.</creatorcontrib><creatorcontrib>Chang, T.‐M.</creatorcontrib><creatorcontrib>Chang, C.‐C.</creatorcontrib><title>Prospective randomized controlled trial comparing treatment efficacy and tolerance of picosecond alexandrite laser with a diffractive lens array and triple combination cream in female asian patients with melasma</title><title>Journal of the European Academy of Dermatology and Venereology</title><addtitle>J Eur Acad Dermatol Venereol</addtitle><description>Background
Recent evidence suggests melasma to be a photoaging disorder. Triple combination creams (TCC: fluocinolone acetonide 0.01%, hydroquinone 4% and tretinoin 0.05%) remain the gold standard treatment. Picosecond alexandrite laser treatment using a diffractive lens array (DLA) has been identified to be effective for improving photoaging conditions.
Objective
We aimed to compare the efficacy and tolerance of the picosecond alexandrite laser with those of DLA and TCC in female Asian patients with melasma.
Methods
Twenty‐nine patients were randomly assigned to group A1 (3 laser sessions at 4‐week intervals), A2 (5 laser sessions at 4‐week intervals) or B (TCC daily for at least 8 weeks and then tapered until the final evaluation). The Melasma Area, Severity Index (MASI) score and VISIA were assessed at baseline, week 12 and week 20. By week 20, the follow‐up periods for groups A1 and A2 were 3 months and 1 month, respectively.
Results
Nine, 11 and 6 participants in groups A1, A2 and B completed the study, respectively. MASI scores were significantly improved in all 3 groups at weeks 12 and 20. In groups A1, A2 and B, the improvement rates at week 20 were 53%, 38% and 50%, respectively. VISIA® analysis additionally revealed a significant improvement in spots, porphyria, pores and brown spots after 3 laser sessions (P < 0.05). Group A2 showed greater improvements than group A1 in terms of spots, wrinkles and pores; however, only red areas were significantly different (P < 0.001). All side‐effects in the 3 groups were transient and gradually subsided after 1–3 months.
Conclusion
Picosecond alexandrite laser treatment using DLA showed comparable efficacy with TCC for the treatment of melasma. Improvements in texture, spots, wrinkles and pores were observed in the laser groups. Patients with melasma lesions that exhibit telangiectasia may benefit from additional laser treatment sessions.</description><subject>Adult</subject><subject>Asian Continental Ancestry Group</subject><subject>Combined Modality Therapy</subject><subject>Drug Combinations</subject><subject>Female</subject><subject>Fluocinolone Acetonide - administration & dosage</subject><subject>Humans</subject><subject>Hydroquinones - administration & dosage</subject><subject>Lasers, Solid-State - therapeutic use</subject><subject>Melanosis - drug therapy</subject><subject>Melanosis - surgery</subject><subject>Middle Aged</subject><subject>Ointments</subject><subject>Prospective Studies</subject><subject>Single-Blind Method</subject><subject>Treatment Outcome</subject><subject>Tretinoin - administration & dosage</subject><issn>0926-9959</issn><issn>1468-3083</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kcFuFSEUhonR2Gt14QuYs3UxLQzcmWFpqq2aJrpo3U7OwEFpGGYC2Hp9TV9I6lR3sgHO-fn-E37GXgp-Iuo6vbG3J2KvpXrEdkJ1QyP5IB-zHddt12i910fsWc43nHMh9sNTdiSF0kr3csd-fU5LXskUf0uQMNpl9j_JglliSUsI9ViSx1AL84rJx6_1TlhmigXIOW_QHKC-g7IEqgBDsDhYvVkyVYgFDPSj9pMvBAEzJbjz5RsgWO9cws05UMyAKeEDK_k10L3n5CMWv0Qw1XUGH8HRXJGA2WOEtTbrJHljzlQNZnzOnjgMmV487Mfs-vzd1dn75vLTxYezN5eNke1eNa1DbbUVamiNlcIRV6Kb-kn2U4tTR0p1veylkdIOaugUta6lduq5MkZow-Uxe71xTf3DnMiNa_IzpsMo-HgfzFiDGf8EU7WvNu36fZrJ_lP-TaIKTjfBnQ90-D9p_Pj2y4b8DdE6nqU</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Wang, Y.‐J.</creator><creator>Lin, E.‐T.</creator><creator>Chen, Y.‐T.</creator><creator>Chiu, P.‐C.</creator><creator>Lin, B.‐S.</creator><creator>Chiang, H.‐M.</creator><creator>Huang, Y.‐H.</creator><creator>Wang, K.‐Y.</creator><creator>Lin, H.‐Y.</creator><creator>Chang, T.‐M.</creator><creator>Chang, C.‐C.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>202003</creationdate><title>Prospective randomized controlled trial comparing treatment efficacy and tolerance of picosecond alexandrite laser with a diffractive lens array and triple combination cream in female asian patients with melasma</title><author>Wang, Y.‐J. ; Lin, E.‐T. ; Chen, Y.‐T. ; Chiu, P.‐C. ; Lin, B.‐S. ; Chiang, H.‐M. ; Huang, Y.‐H. ; Wang, K.‐Y. ; Lin, H.‐Y. ; Chang, T.‐M. ; Chang, C.‐C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3254-2fa9d9d1482cd31fe0416b7b37b2ab6e4467373c33d84864e2f2e2b704cc19c03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Asian Continental Ancestry Group</topic><topic>Combined Modality Therapy</topic><topic>Drug Combinations</topic><topic>Female</topic><topic>Fluocinolone Acetonide - administration & dosage</topic><topic>Humans</topic><topic>Hydroquinones - administration & dosage</topic><topic>Lasers, Solid-State - therapeutic use</topic><topic>Melanosis - drug therapy</topic><topic>Melanosis - surgery</topic><topic>Middle Aged</topic><topic>Ointments</topic><topic>Prospective Studies</topic><topic>Single-Blind Method</topic><topic>Treatment Outcome</topic><topic>Tretinoin - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Y.‐J.</creatorcontrib><creatorcontrib>Lin, E.‐T.</creatorcontrib><creatorcontrib>Chen, Y.‐T.</creatorcontrib><creatorcontrib>Chiu, P.‐C.</creatorcontrib><creatorcontrib>Lin, B.‐S.</creatorcontrib><creatorcontrib>Chiang, H.‐M.</creatorcontrib><creatorcontrib>Huang, Y.‐H.</creatorcontrib><creatorcontrib>Wang, K.‐Y.</creatorcontrib><creatorcontrib>Lin, H.‐Y.</creatorcontrib><creatorcontrib>Chang, T.‐M.</creatorcontrib><creatorcontrib>Chang, C.‐C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Journal of the European Academy of Dermatology and Venereology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Y.‐J.</au><au>Lin, E.‐T.</au><au>Chen, Y.‐T.</au><au>Chiu, P.‐C.</au><au>Lin, B.‐S.</au><au>Chiang, H.‐M.</au><au>Huang, Y.‐H.</au><au>Wang, K.‐Y.</au><au>Lin, H.‐Y.</au><au>Chang, T.‐M.</au><au>Chang, C.‐C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective randomized controlled trial comparing treatment efficacy and tolerance of picosecond alexandrite laser with a diffractive lens array and triple combination cream in female asian patients with melasma</atitle><jtitle>Journal of the European Academy of Dermatology and Venereology</jtitle><addtitle>J Eur Acad Dermatol Venereol</addtitle><date>2020-03</date><risdate>2020</risdate><volume>34</volume><issue>3</issue><spage>624</spage><epage>632</epage><pages>624-632</pages><issn>0926-9959</issn><eissn>1468-3083</eissn><abstract>Background
Recent evidence suggests melasma to be a photoaging disorder. Triple combination creams (TCC: fluocinolone acetonide 0.01%, hydroquinone 4% and tretinoin 0.05%) remain the gold standard treatment. Picosecond alexandrite laser treatment using a diffractive lens array (DLA) has been identified to be effective for improving photoaging conditions.
Objective
We aimed to compare the efficacy and tolerance of the picosecond alexandrite laser with those of DLA and TCC in female Asian patients with melasma.
Methods
Twenty‐nine patients were randomly assigned to group A1 (3 laser sessions at 4‐week intervals), A2 (5 laser sessions at 4‐week intervals) or B (TCC daily for at least 8 weeks and then tapered until the final evaluation). The Melasma Area, Severity Index (MASI) score and VISIA were assessed at baseline, week 12 and week 20. By week 20, the follow‐up periods for groups A1 and A2 were 3 months and 1 month, respectively.
Results
Nine, 11 and 6 participants in groups A1, A2 and B completed the study, respectively. MASI scores were significantly improved in all 3 groups at weeks 12 and 20. In groups A1, A2 and B, the improvement rates at week 20 were 53%, 38% and 50%, respectively. VISIA® analysis additionally revealed a significant improvement in spots, porphyria, pores and brown spots after 3 laser sessions (P < 0.05). Group A2 showed greater improvements than group A1 in terms of spots, wrinkles and pores; however, only red areas were significantly different (P < 0.001). All side‐effects in the 3 groups were transient and gradually subsided after 1–3 months.
Conclusion
Picosecond alexandrite laser treatment using DLA showed comparable efficacy with TCC for the treatment of melasma. Improvements in texture, spots, wrinkles and pores were observed in the laser groups. Patients with melasma lesions that exhibit telangiectasia may benefit from additional laser treatment sessions.</abstract><cop>England</cop><pmid>31494973</pmid><doi>10.1111/jdv.15934</doi><tpages>9</tpages></addata></record> |
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| identifier | ISSN: 0926-9959 |
| ispartof | Journal of the European Academy of Dermatology and Venereology, 2020-03, Vol.34 (3), p.624-632 |
| issn | 0926-9959 1468-3083 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Asian Continental Ancestry Group Combined Modality Therapy Drug Combinations Female Fluocinolone Acetonide - administration & dosage Humans Hydroquinones - administration & dosage Lasers, Solid-State - therapeutic use Melanosis - drug therapy Melanosis - surgery Middle Aged Ointments Prospective Studies Single-Blind Method Treatment Outcome Tretinoin - administration & dosage |
| title | Prospective randomized controlled trial comparing treatment efficacy and tolerance of picosecond alexandrite laser with a diffractive lens array and triple combination cream in female asian patients with melasma |
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