Case reports in dermatology · 2026
High-Potency Depigmenting Mask Delivered via 1,927-nm Fractional Laser in Refractory Melasma: A Pilot Case Series.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Piquero-Casals Jaime, Mir-Bonafé Juan Francisco, Rozas-Muñoz Eduardo, Piquero-Casals Vanesa, Morgado-Carrasco Daniel
Аннотация
INTRODUCTION: Melasma is a chronic, relapsing hyperpigmentation disorder and may remain refractory despite multiple topical agents and procedural approaches.
CASE PRESENTATION: We report a case series of six women with Fitzpatrick skin types III-V and longstanding, treatment-resistant facial melasma managed with a multimodal protocol consisting of (1) a 16-week home regimen (twice-daily depigmenting cosmeceutical serum and daily high-protection sunscreen) and (2) two sessions of low-energy, low-density 1,927-nm fractional thulium laser at 4-week intervals, immediately followed by laser-assisted delivery of a compounded depigmenting mask (hydroquinone, retinoic acid, kojic acid, triamcinolone acetonide, vitamins C and E). Clinical response was assessed using the Melasma Severity Scale (MSS), standardized photography, and patient satisfaction. At week 16, all patients improved: 4 achieved >75% clinical improvement and 2 achieved 50-75% improvement, with high satisfaction and no significant adverse events beyond transient darkening and mild desquamation. Clinical benefits remained stable 12 weeks after the final laser session.
CONCLUSION: This case series suggests that 1,927-nm fractional thulium laser-assisted delivery of a high-potency depigmenting compound, supported by topical priming and strict photoprotection, may be a feasible option for selected patients with refractory melasma.
CASE PRESENTATION: We report a case series of six women with Fitzpatrick skin types III-V and longstanding, treatment-resistant facial melasma managed with a multimodal protocol consisting of (1) a 16-week home regimen (twice-daily depigmenting cosmeceutical serum and daily high-protection sunscreen) and (2) two sessions of low-energy, low-density 1,927-nm fractional thulium laser at 4-week intervals, immediately followed by laser-assisted delivery of a compounded depigmenting mask (hydroquinone, retinoic acid, kojic acid, triamcinolone acetonide, vitamins C and E). Clinical response was assessed using the Melasma Severity Scale (MSS), standardized photography, and patient satisfaction. At week 16, all patients improved: 4 achieved >75% clinical improvement and 2 achieved 50-75% improvement, with high satisfaction and no significant adverse events beyond transient darkening and mild desquamation. Clinical benefits remained stable 12 weeks after the final laser session.
CONCLUSION: This case series suggests that 1,927-nm fractional thulium laser-assisted delivery of a high-potency depigmenting compound, supported by topical priming and strict photoprotection, may be a feasible option for selected patients with refractory melasma.