Melasma is a frequent reason for dermatological consultations, and especially when considering the aesthetic prejudice associated with this pigmentary disorder.

Melasma is an acquired hypermelanosis of the face that slowly and symmetrically develops with brown to dark–brown macules. Hypermelanosis can be epidermal or dermal; however, the mixed variety occurs more frequently. Consequently, different reactions to the treatment may also be observed in the same patient, depending on the treated area. The best therapeutic results are obtained in epidermal hypermelanosis.

Depigmenting agents for topical use are generally considered as a first-line treatment for melasma. Rigorous photoprotection must be combined with all kinds of treatments.

Treating a melasma that is resistant to topical depigmenting therapy with pulsed light can be interesting. Although the risk of post-inflammatory hyperpigmentation (PIH) is always imminent, a number of medical staff have used this method successfully, and particularly among patients of Asian descent.

Figure 1 Phototype III, 39-year-old female patient with melasma that manifests as small spots all over the cheeks (A), and which was resistant to topical depigmenting treatment. Alternative treatment was performed using FT pulsed light with 520 nm filter, 14 J energy and 2-pulses emission with Ton: 5, and repeated twice with a 1-month interval (B). Maintenance treatment comprises one session during winter to correct summer damage

Figure 1 Phototype III, 39-year-old female patient with melasma that manifests as small spots all over the cheeks (A), and which was resistant to topical depigmenting treatment. Alternative treatment was performed using FT pulsed light with 520 nm filter, 14 J energy and 2-pulses emission with Ton: 5, and repeated twice with a 1-month interval (B). Maintenance treatment comprises one session during winter to correct summer damage

Improvements can be seen after one session, especially in cases of epidermal hypermelanosis. At a later stage, a secondary repigmentation is fairly frequent, though the intensity is less compared with the initial pigmentation.

Repeated pulsed light sessions, combined with a topical depigmentation treatment and rigid sunscreen regimen, can deliver excellent results for patients.

Pulsed light treatment is an excellent indication for actinic or solar lentigo on the face and delicate regions that are normally exposed to sun rays, such as neck, décolleté, and the back of the hands.

Thanks to the multi-pulsed emission mode and efficacy of the skin cooling integrated in the DEKA FT handpiece, pigmentation can be considerably reduced within an average of two sessions. Excellent results are obtained on dark spots, which mostly absorb the light emitted from the handpiece source.

Figure 2 Phototype III, 27-year-old female patient with a 3-year evolution of melasma (A), which was resistant to topical treatments. Alternative treatment was performed using FT pulsed light with 520 nm filter, 14.5 J energy and 2-pulses emission with Ton: 4 and 5. Good results were achieved after 6 days of treatment (B). Partial repigmentation can be seen after 30 days (C). The patient was satisfied and two additional sessions have been scheduled to reduce pigmentation

Figure 2 Phototype III, 27-year-old female patient with a 3-year evolution of melasma (A), which was resistant to topical treatments. Alternative treatment was performed using FT pulsed light with 520 nm filter, 14.5 J energy and 2-pulses emission with Ton: 4 and 5. Good results were achieved after 6 days of treatment (B). Partial repigmentation can be seen after 30 days (C). The patient was satisfied and two additional sessions have been scheduled to reduce pigmentation

Figure 3 Phototype III, 59-year-old female patient with multiple actinic spots on the back of the hands (A). The treatment was repeated twice with a 1-month interval, and performed using FT pulsed light with 520 nm filter, 15 J energy and 2-pulses emission with Ton: 4 and 5 ms (B)

Figure 3 Phototype III, 59-year-old female patient with multiple actinic spots on the back of the hands (A). The treatment was repeated twice with a 1-month interval, and performed using FT pulsed light with 520 nm filter, 15 J energy and 2-pulses emission with Ton: 4 and 5 ms (B)

LOGO DEKA CODE