应用局灶性光热作用技术治疗黄褐斑

目的 观察局灶性光热作用技术治疗黄褐斑的安全性及疗效.方法 36例黄褐斑患者,其中表皮型16例,真皮型5例,混合型15例.病灶局部外涂2%利多卡因乳膏,以能量密度15～20 J/cm~2、波长1 320nm Nd:YAG激光扫描照射病灶,照射3～4遍,每个治疗区产生25个微损伤柱.每3周治疗1次,共治疗4次.治疗后6个月评估疗效及副反应.结果 表皮型及混合型黄褐斑患者经4次治疗后皮肤黑素指数、黄褐斑评分指数及患者满意度明显改善,而真皮型患者临床及主观评估均未取得良好效果.治疗过程中未出现色素沉着、色素减退及瘢痕形成等副作用.结论 局灶性光热作用技术治疗表皮型及混合型黄褐斑安全有效.

Fractional Photothermolysis Technology in Treatment of Melasma

Objective To evaluate the safety and efficiency of fractional photothermolysis technology in the treatment of melasma.Methods Thirty-six melasma patients were employed in the study, in which epidermal, dermal and mixed type of melasma patients were 16 cases, S cases and IS cases, respectively.The local area of the eruption was applied with 2% lidocaine cream topically and treated with 1 320 nm Nd: YAG laser at the pulse energy of 15-20 J/cm~2 for 3-4 times, which resulted in twenty-five micro-injury columns in each treatment area.Four times of treatment were applied with three weeks interval.The efficiency and the side responses of the therapy were evaluated six months after the treatment.Results The melanin index, melasma area and severity index score and the patient self assessment were significantly improved in the epidermal and mixed type of melasma after four times of treatment, while the clinical and the objective assessments had no significant improvement after the treatment in dermal type of melasma.There were lack of severe side responses such as hypo- or hyperpigmenta-tion and scar formation in the treatment.Conclusions Fractional photothermolysis technology can be widely used in the epidermal and mixed types of melasma.