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Repeated Treatment Protocols for Melasma and Acquired Dermal Melanocytosis
Authors:KOTARO YOSHIMURA  MD    KATSUJIRO SATO  MD    EMIKO AIBA-KOJIMA  MD    DAISUKE MATSUMOTO  MD    CHIAKI MACHINO  MD    TAKASHI NAGASE  MD    KOICHI GONDA  MD     ISAO KOSHIMA  MD
Affiliation:Department of Plastic Surgery, University of Tokyo, School of Medicine, Tokyo, Japan. yoshimura@cosmetic-medicine.jp
Abstract:BACKGROUND AND OBJECTIVE: Melasma and acquired dermal melanocytosis (ADM; acquired bilateral nevus of Ota-like macules) are both seen most commonly symmetrically on the face of women with darker skin and are also known as difficult conditions to treat. METHODS: Our topical bleaching protocol with 0.1 to 0.4% tretinoin gel and 5% hydroquinone was performed repeatedly (1-3 times) for melasma (n=163), and a combination treatment with topical bleaching and Q-switched ruby (QSR) laser was performed repeatedly (1-3 times) for ADM (n=62). RESULTS: There is a significant correlation between clinical results (clearance of pigmentation) and the number of sessions in both melasma (p=.019) and ADM (p<.0001). CONCLUSION: The repeated treatment protocol for melasma and ADM showed successful clinical results compared with conventional ones, and they may be applied to other pigment conditions. It may be better that epidermal and dermal pigmentations are treated separately, especially in dark-skinned people who are more likely to suffer postinflammatory hyperpigmentation after inflammation-inducing therapies.
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