Treatment of Refractory Melasma with Microwave-generated, Atmospheric-pressure, Non-thermal Nitrogen Plasma
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Periorbital melasma is often refractory to treatment and highly associated with rebound hyperpigmentation or mottled hypopigmentation after laser treatment in Asian patients. In this report, we describe 2 patients with cluster-1 periorbital melasma and 1 patient with cluster-2 periorbital melasma who experienced remarkable clinical improvements after microwave-generated, atmospheric-pressure, non-thermal nitrogen plasma treatments. All patients exhibited limited clinical responses after combination treatments with topical bleaching agents, systemic oral tranexamic acid, and low-fluenced Q-switched neodymium (Nd):yttrium-aluminum-garnet (YAG) lasers. Low-energy nitrogen plasma treatment at 0.75 J elicited remarkable clinical improvement in the periorbital melasma lesions without post-laser therapy rebound hyperpigmentation and mottled hypopigmentation. We deemed that a single pass of nitrogen plasma treatment at 0.75 J induces mild microscopic thermal tissue coagulation and modification within the epidermis while preserving the integrity of the basement membrane in patients with periorbital melasma. Accordingly, nitrogen plasma-induced dermal tissue regeneration could play a role in the treatment of melasma lesions.
Abstract
Periorbital melasma is often refractory to treatment and highly associated with rebound hyperpigmentation or mottled hypopigmentation after laser treatment in Asian patients. In this report, we describe 2 patients with cluster-1 periorbital melasma and 1 patient with cluster-2 periorbital melasma who experienced remarkable clinical improvements after microwave-generated, atmospheric-pressure, non-thermal nitrogen plasma treatments. All patients exhibited limited clinical responses after combination treatments with topical bleaching agents, systemic oral tranexamic acid, and low-fluenced Q-switched neodymium (Nd):yttrium-aluminum-garnet (YAG) lasers. Low-energy nitrogen plasma treatment at 0.75 J elicited remarkable clinical improvement in the periorbital melasma lesions without post-laser therapy rebound hyperpigmentation and mottled hypopigmentation. We deemed that a single pass of nitrogen plasma treatment at 0.75 J induces mild microscopic thermal tissue coagulation and modification within the epidermis while preserving the integrity of the basement membrane in patients with periorbital melasma. Accordingly, nitrogen plasma-induced dermal tissue regeneration could play a role in the treatment of melasma lesions.
참고문헌 (10)
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