MelAsma
Melasma is manifested in the skin brown spots simulating maps and located most prone in the center of the face. Topical depigmenting are used most frequently in this entity. Within these, Hydroquinone is the only product that has shown considerable efficiency but requires, be made by a laboratory to ensure stability and tolerance. Hydroquinone can create rebound reactions if suddenly stop and in the majority of cases; be used for years as you will notice, that the spots return once the cream is discontinued. The combination of laser and hydroquinone really is necessary when it is required that the melanocyte forget to stains. The laser can generate more pigmentation without Hydroquinone one or two months after the session. For this experience, it was concluded that management should be complementary and not an alternative. Fraxel® laser changes the initial period of swelling observed with the use of creams from two months to two hours. It is their biggest advantage. When used Fraxel Thulium can get a faster response in selected cases. All treatment scheme aims to remove pigment producing cells better control of inflammation. Occasionally, you may require the intervention of Melasma lasers exclusively in patients who can not tolerate creams. However, they are not the easiest cases. A scheme of this type offers more than 20 sessions switched Nd-YAG lasers with low power without using skin lightening but have reported a high incidence of exacerbations around Session 7 (1). This scheme is absolutely not feasible. Finally, do not forget proper camouflage. There are new versions of micro-mineralized materials that we have tested, which immediately relieved the melasma, but need to learn how. Camouflage obstructs sun exposure and conceals the side effects of treatment such as redness and timing of the appearance of the result; are two gains. Doctors also have to learn the techniques of camouflage. We Ochronosis cases. In these cases, treatment requires a microsurgical approach which gets results from session to session.
| Melasma Make-up |
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| Ochronosis | |
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| Before | One year after two laser sessions. |
(1) Lasers in (Surgery and Medicine 44:117–124 (2012).