| Abstract: | Melasma represents a pigmentary disorder that is difficult to treat. This study aimsto broadly review the use of ablative lasers (Er:YAG and CO2) in the treatment ofmelasma, presenting the level of evidence of studies published to date. A total of 75patients were enrolled in four case series studies (n=39), one controlled clinicaltrial (n=6) and one randomized controlled clinical trial (n=30). Studies on theEr:YAG laser showed better results with the use of short square-shaped pulses, whichdetermined low rates of post-inflammatory hyperpigmentation and long-lastingmaintenance of results. Likewise, studies on the CO2 laser proved the benefits ofshort pulse duration along with low-density energy. Post-treatment maintenance withthe use of antipigmenting creams was necessary and effective to sustain long-termresults. Ablative lasers may represent another useful and effective tool againstmelasma. Postinflammatory hyperpigmentation and difficulty in sustaining long-termresults still represent the main limitations to a broader use of ablative lasers.Based on actual evidence, the use of this technology should be restricted to patientswith recalcitrant disease. Further studies will help establish optimal laserparameters and treatment regimens. |
