Energy-based devices for melasma and postinflammatory hyperpigmentation

Introduction

Melasma and postinflammatory hyperpigmentation (PIH) are conditions commonly encountered by dermatologists, and they are often distressing to patients. While PIH can improve with time once the inflammatory process is controlled, melasma is a condition that often requires prolonged treatment and maintenance. There are numerous treatment options, ranging from UV protection and topical therapies (such as hydroquinone), to more procedural-based options (chemical peels, micro-needling, and energy-based devices).

Objective

This review will focus on the treatment of melasma and PIH with various energy-based therapies, including laser devices, intense pulsed light (IPL), high-frequency ultrasound, and radiofrequency devices.

Methods

References were collected by using Pubmed with search terms of “laser”, “melasma”, “post-inflammatory hyperpigmentation”, and “energy-based devices.”

Findings

Lasers and IPL target pigment in the epidermis and dermis by using the appropriate wavelengths and principles such as thermal relaxation time and photoacoustic damage. Other lasers, such as pulsed-dye laser (PDL), target the vascular component of melasma. Used alone or in combination with topical treatments, these devices provide improvement in melasma and PIH. In addition, some authors have studied the use of these devices, such as fractionated lasers, in device-assisted drug delivery of topical therapies.

Conclusion

While there is a benefit to the use of these devices, this change is usually temporary and balanced against the side effects of dyspigmentation and scarring. Therefore, these treatments are best used in combination, with a maintenance program that employs both topical therapies, procedures, and energy-based devices.