Melasma facial

Fig. 10.4. a Facial melasma in skin type 111. b Note significant improvement after combination salicylic acid/TCA peel... 

As monotherapy, facial melasma showed statistically significant improvement with the use of tretinoin 0.1% for 40 weeks even in darker skin patients [85], Sequential [154] or dual combination with HQ [79] provided good to excellent results with mild to moderate reactions to tretinoin that lessened as therapy was continued. 

Balkrishnan R, Kelly AP, McMichael A et al (2004) Improved quality of life with effective treatment of facial melasma the Pigment trial. J Drugs Dermatol 3 377-381... 

Grimes P, KeUy P, Toork H et al (2006) Community-based trial of a triple-combination agent for the treatment of facial melasma. Cutis 77 177-184... 

Patients with melasma (Eig. 2.3) applied topical sunscreens (sun protection factor 15) and 10% glycolic acid lotion at night for 2 weeks. They were then treated with 50% glycolic acid facial peels once a month for 3 consecutive months. At regular intervals and at the end of the follow-up period (3 months) after the last peel, the degree of improvement in pigmentation was assessed by measuring MASl (Melasma Area and Severity Index) [11]. 

Javaheri SM, Handa S, Kaur I, Kumar B (2001) Safety and efficacy of glycolic acid facial peel in Indian women with melasma. Int J Dermatol 40(5) 354-357... 

The safety and efficacy of a series of glycolic acid facial peels were investigated in 25 Indian women with melasma [16]. Patients were treated with 50% glycolic acid peels monthly for 3 months. Improvement was noted in 91% of patients with maximal clearing occurring in patients classified with epidermal melasma. Side effects were observed in one patient who developed brow hyperpigmentation. 

Melasma Facial pigmentation found across the upper cheeks, nose, and forehead. 

Not understood. It seems possible that the facial pigmentation (melasma, chloasma) that can occur with oral contraceptives may have been additive with the effects of the minocycline. ... 

Tested for once-daily spot treatment of darker pigmented facial areas for 8 weeks on 20 melasma patients, a 42.3% decrease in MASI score was shown [130]. 

Liberman R, Moy L (2008) Receptor Expression in melasma results from facial skin of affected patients. J Drugs Dermatol 7(5) 463-465... 

In a study from Korea, by Lee and Kim, 35 patients with facial acne were treated with 30% salicylic acid peels biweekly for 12 weeks. Lesion counts and Dr. Cunliffe s scores revealed a decrease in both inflammatory and noninflammatory acne lesions. The peels were also well tolerated [17]. In another prospective, noncomparative study of 268 Asian patients who underwent 30% salicylic acid peels weekly for 8 weeks for various indications including melasma, acne vulgaris, freckles, postinflammatory scars/pigmentation, the peels were tolerated well. Mild discomfort, bum-... 

For the treatment of melasma (symmetric progressive hyperpigmentation of the facial skin), a study was done comparing modified Jessner s solution and 15 % trichloroacetic acid (TCA) versus 15 % TCA alone [318], Modified Jessner s solution (see above) was found to be useful as an adjuvant treatment with 15 % TCA [318]. 

Facial Plastic Surgery Clinics of North America 18(1) 111-131 Sarkar R, Kaur C, Bhalla M et al 2002 The combination of glycolic acid peels with a topical regimen in the treatment of melasma in dark-skinned patients a comparative study. Dermatologic Surgery 28 828-832... 

Erbil H, Sezer E, Ta tan B et al 2007 Efficacy and safety of serial glycolic acid peels and a topical regimen in the treatment of recalcitrant melasma. Journal of Dermatology 34 25-30 Fabbrocini G, De Padova MP, Tbsti A 2009 Chemical peels what s new and what isn t new but still works well. Facial Plastic Surgery 25 329—336... 

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