CLSM And Clinical Observation On Melasma Treatment With Great Spot Low Energy Q Switch Nd:yag Laser

Background:Melasma is a very common hyperpigmentation clinical disease, usually occurs in the exposed domain, mostly light brown or light black spots, irregularly shaped, symmetrical distribution in the amount of brow, cheek, nose, upper lip and other facial skin. As melasma usually occurs on the face and biopsy is an invasive examination, the patient is not easy to accept and routine pathologyical examination hardly implement. Confocal laser scanning microscopy (CLSM) is a skin imaging system based on the optical confocal priciples. CLSM can be non-invasive, in situ, real-time, dynamic examination of the skin. The etiology of the disease maybe related to endocrine, genetic, ultraviolet radiation, pregnancy, oral contraceptives, visceral disease and microbial imbalances. And these factors result in melanocyte hyperfunctioning and accelerate the formation of melanin. Therefore, the basic principles of melasma treatment are to inhibit the activity and proliferation of melanocytes, block the formation of black pigment particles and accelerate their degradation. The traditional treatment including bleaching agents, sunscreen agents, skin peeling technique and Chinese Herbal Drugs, but it is easy to relapse. Recently, some scholars and dermatology experts suggest to treat melasma with laser, and results vary.Objective: To research structural charaters of chlosma skin lesions by adopting CLSM and to determine whether Chinese with melasma will respond to QS Nd:YAG laser.Methods: A group(n=45) of patients previously diagnosed with facial melasma were selected and their pigment distribution was evaluated by CLSM. The patients were treated with QS Nd:YAG laser at approximately 1 week intervals. Eleven to twenty treatments were performed for each patient.Results:â‘ In 45 melasma patients treated by QS Nd:YAG laser, 8 cases basically cured (17.78%), 25 cases are markedly effective (55.56%), 12 cases improved (26.67%) and only 1 case is uneffective (2.22%). The effective rate is 73.33%.â‘¡Compared with surrounding normal skin around the melasma skin lesions, all layers of melasma skin lesions epidermal melanin particles increased with/without dermal melanin granules appeared. The melasma skin lesions epidermal melanin granules decrease significantly after laser treatment.Conclusions: CLSM is effective methods to diagnose melasma and judge the curative effect of laser treatment. QS Nd:YAG laser is a useful treatment modality for chinese women who have melasma.