Pulsed alexandrite laser for treatment of melasma in Asian patients.

Background: Melasma is a common acquired facial hypermelanosis with irregular brownish macules and patches. The clinical course is often fluctuated and refractory to treatment. The present study was conducted to evaluate the efficacy and safety of pulsed alexandrite laser for the treatment of melasma. Materials and methods: In the present study, we enrolled Asian patients with melasma. All the patients received four monthly treatments with a pulsed alexandrite laser. The severity of melasma was evaluated by a blinded dermatologist, using the Modified Melasma Area and Severity Index (MMASI), and by patient assessment, using a visual analogue scale, at baseline, before each treatment, and at the 1-month and 3-month follow-up visits after the last treatment. Results: Twenty-three patients completed all treatments and follow-up visits. The MMASI scores decreased significantly from 8.71 +/- 5.83 at baseline to 6.07 +/- 4.65 after four sessions of treatment (P < 0.05) and 6.91 +/- 4.97 at 3 months after the last laser treatment (P < 0.05). After 4 sessions of treatment, 10 patients (43.5%) described their improvement as marked and excellent (>60% improvement). The treatments were well tolerated with only mild skin reaction. Conclusion: In the present study, we demonstrated that the pulsed alexandrite laser is safe and effective to treat melasma in Asian skin.