Most therapies designed to treat melasma reduce the hyperpigmentation by targeting the melanocytes with the application of phenols, retinoids, corticosteroids and their combinations. At times, invasive procedures are also undertaken with lasers and other light sources. However, results from such treatments are most often mixed. Now, according to a new study, the use of a copper bromide 578 nm dual/yellow laser can significantly impact the hyperpigmentation seen in melasma lesions. Researchers from Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea., say that reducing the vascular endothelial growth factor (VEGF) seems to be an excellent approach in successfully treating melasma and significantly reducing hyperpigmentation.

Highlights of the study
a. In this study, 20 female Korean patients with facial melasma were treated with a copper bromide dual 578 nm yellow laser.
b. Treatments were given once a week for 3 weeks.
c. The vascular structures within the melasma lesions were targetted.
d. Biopsies of pre-treatment and post-treatment melasma lesions were taken for histologic confirmation of study results.
e. Researchers performed immunohistochemistry to determine the expression of factor VIIIa-related antigen, VEGF and thrombospondin in melasma.
f. They also quantified erythema intensity and pigmentation with a Mexameter (Courage-Khazaka).
g. It was seen that the yellow laser was able to reduce the size and number of vessels within the melasma lesions, reducing the erythema of the treated lesions, which in turn reduced the perceived pigment within the lesions.
h. Patients exhibited a decrease in both the pigmentation of the melasma lesions reflected in the improvement of the melasma area and severity index (MASI) and physicians global assessment (PGA) scores, as well as the VEGF in post-treatment lesional skin compared to pre-treatment.
i. Patients treated with the yellow laser showed longer-lasting results than with any other treatment.