1,927-nm laser unveils improvements for melasma patients

DANA POINT, CALIF. – Patients with melasma who underwent treatment with a new low-energy and low-density nonablative fractional 1,927-nm diode laser experienced significant reduction of hyperpigmentation with limited side effects, a single-center study demonstrated.

At a meeting sponsored by SkinCare Physicians and Northwestern University, Dr. Roy G. Geronemus discussed his experience treating patients with the FDA-cleared technology, which is known as the Clear + Brilliant Permea.

Dr. Geronemus of the Laser and Skin Surgery Center of New York noted that existing laser treatments have so far failed to yield a consistent and long-term reduction in pigmentation, especially in patients with darker skin types. "Many current [laser] treatments for melasma make the condition worse," he said "What we ideally need is something that will be helpful, will not make it worse, and that can be repeated, because [melasma] probably will recur over time."

In an ongoing prospective study, Dr. Geronemus and his associates evaluated the 1,927-nm diode laser in melasma patients with a hunch that it would improve pigmentation and appearance with an improved safety profile and overall treatment outcomes. They enrolled patients aged 18-65 years with Fitzpatrick skin types I-VI who had clinical evidence of melasma or postinflammatory hyperpigmentation. They excluded patients who were either pregnant, breast-feeding, contemplating pregnancy, or not using effective means of birth control, as well as those known to be hypersensitive to light exposure and those with a history of melanoma or nonmelanoma skin cancer, keloidal scarring, immunosuppression, or immune deficiency disorder. Images were taken at baseline, prior to each treatment, and at follow-up using the Canfield VISIA complexion analysis system.

Up to six treatments were performed every 2 weeks, Dr. Geronemus said, with spot sizes of 100-180 mcm, energy of 5 mJ, 5-7.5% treatment coverage, and an average of 4-12 passes.

The researchers asked patients to rate their pain after each treatment, as well as their overall improvement in pigmentation. Pain was assessed on an 11-point scale, with 0 being none and 10 being "intolerable." Pigmentation improvement was measured on a 5-point scale, with 0 being none, 1 being mild (1-25%), 2 being moderate (26-50%), 3 being marked (51-75%), and 4 being very significant (76-100%). At the final 3-month visit, patients were asked to rate their overall satisfaction with the treatment on a 5-point scale ranging from very dissatisfied (1) to very satisfied (5).

Dr. Geronemus presented results from 14 patients who had completed 3-month follow-up visits. These 14 women included 10 with melasma and 4 with postinflammatory hyperpigmentation. The mean age of the patients was 42 years, and 9 had Fitzpatrick skin types I-III.

The patients rated their pain as 3.25 out of 10, their overall pigment improvement as 3 out of 4, and their overall satisfaction with the procedure as a 4.33 out of 5, Dr. Geronemus reported. "This is often technique sensitive," he said of the procedure. "I’ll have physicians call me up and say, ‘I’m not getting any results.’ I think you need 10-12 passes to get the [optimal] results."

The most common side effect was erythema, which typically resolved within 1 day. Though the device is effective as monotherapy, Dr. Geronemus pointed out that it is "ideally suited for combination therapy with a mild hydroquinone."

Dr. Geronemus disclosed that he serves on the medical advisory boards for Zeltiq, Syneron/Candela, and Cynosure. He also serves as an investigator for numerous device and pharmaceutical companies, and he holds stock in Zeltiq and OnLight Sciences.

[email protected]

DANA POINT, CALIF. – Patients with melasma who underwent treatment with a new low-energy and low-density nonablative fractional 1,927-nm diode laser experienced significant reduction of hyperpigmentation with limited side effects, a single-center study demonstrated.

At a meeting sponsored by SkinCare Physicians and Northwestern University, Dr. Roy G. Geronemus discussed his experience treating patients with the FDA-cleared technology, which is known as the Clear + Brilliant Permea.

Dr. Geronemus of the Laser and Skin Surgery Center of New York noted that existing laser treatments have so far failed to yield a consistent and long-term reduction in pigmentation, especially in patients with darker skin types. "Many current [laser] treatments for melasma make the condition worse," he said "What we ideally need is something that will be helpful, will not make it worse, and that can be repeated, because [melasma] probably will recur over time."

In an ongoing prospective study, Dr. Geronemus and his associates evaluated the 1,927-nm diode laser in melasma patients with a hunch that it would improve pigmentation and appearance with an improved safety profile and overall treatment outcomes. They enrolled patients aged 18-65 years with Fitzpatrick skin types I-VI who had clinical evidence of melasma or postinflammatory hyperpigmentation. They excluded patients who were either pregnant, breast-feeding, contemplating pregnancy, or not using effective means of birth control, as well as those known to be hypersensitive to light exposure and those with a history of melanoma or nonmelanoma skin cancer, keloidal scarring, immunosuppression, or immune deficiency disorder. Images were taken at baseline, prior to each treatment, and at follow-up using the Canfield VISIA complexion analysis system.

Up to six treatments were performed every 2 weeks, Dr. Geronemus said, with spot sizes of 100-180 mcm, energy of 5 mJ, 5-7.5% treatment coverage, and an average of 4-12 passes.

The researchers asked patients to rate their pain after each treatment, as well as their overall improvement in pigmentation. Pain was assessed on an 11-point scale, with 0 being none and 10 being "intolerable." Pigmentation improvement was measured on a 5-point scale, with 0 being none, 1 being mild (1-25%), 2 being moderate (26-50%), 3 being marked (51-75%), and 4 being very significant (76-100%). At the final 3-month visit, patients were asked to rate their overall satisfaction with the treatment on a 5-point scale ranging from very dissatisfied (1) to very satisfied (5).

Dr. Geronemus presented results from 14 patients who had completed 3-month follow-up visits. These 14 women included 10 with melasma and 4 with postinflammatory hyperpigmentation. The mean age of the patients was 42 years, and 9 had Fitzpatrick skin types I-III.

The patients rated their pain as 3.25 out of 10, their overall pigment improvement as 3 out of 4, and their overall satisfaction with the procedure as a 4.33 out of 5, Dr. Geronemus reported. "This is often technique sensitive," he said of the procedure. "I’ll have physicians call me up and say, ‘I’m not getting any results.’ I think you need 10-12 passes to get the [optimal] results."

The most common side effect was erythema, which typically resolved within 1 day. Though the device is effective as monotherapy, Dr. Geronemus pointed out that it is "ideally suited for combination therapy with a mild hydroquinone."

Dr. Geronemus disclosed that he serves on the medical advisory boards for Zeltiq, Syneron/Candela, and Cynosure. He also serves as an investigator for numerous device and pharmaceutical companies, and he holds stock in Zeltiq and OnLight Sciences.

[email protected]

DANA POINT, CALIF. – Patients with melasma who underwent treatment with a new low-energy and low-density nonablative fractional 1,927-nm diode laser experienced significant reduction of hyperpigmentation with limited side effects, a single-center study demonstrated.

At a meeting sponsored by SkinCare Physicians and Northwestern University, Dr. Roy G. Geronemus discussed his experience treating patients with the FDA-cleared technology, which is known as the Clear + Brilliant Permea.

Dr. Geronemus of the Laser and Skin Surgery Center of New York noted that existing laser treatments have so far failed to yield a consistent and long-term reduction in pigmentation, especially in patients with darker skin types. "Many current [laser] treatments for melasma make the condition worse," he said "What we ideally need is something that will be helpful, will not make it worse, and that can be repeated, because [melasma] probably will recur over time."

In an ongoing prospective study, Dr. Geronemus and his associates evaluated the 1,927-nm diode laser in melasma patients with a hunch that it would improve pigmentation and appearance with an improved safety profile and overall treatment outcomes. They enrolled patients aged 18-65 years with Fitzpatrick skin types I-VI who had clinical evidence of melasma or postinflammatory hyperpigmentation. They excluded patients who were either pregnant, breast-feeding, contemplating pregnancy, or not using effective means of birth control, as well as those known to be hypersensitive to light exposure and those with a history of melanoma or nonmelanoma skin cancer, keloidal scarring, immunosuppression, or immune deficiency disorder. Images were taken at baseline, prior to each treatment, and at follow-up using the Canfield VISIA complexion analysis system.

Up to six treatments were performed every 2 weeks, Dr. Geronemus said, with spot sizes of 100-180 mcm, energy of 5 mJ, 5-7.5% treatment coverage, and an average of 4-12 passes.

The researchers asked patients to rate their pain after each treatment, as well as their overall improvement in pigmentation. Pain was assessed on an 11-point scale, with 0 being none and 10 being "intolerable." Pigmentation improvement was measured on a 5-point scale, with 0 being none, 1 being mild (1-25%), 2 being moderate (26-50%), 3 being marked (51-75%), and 4 being very significant (76-100%). At the final 3-month visit, patients were asked to rate their overall satisfaction with the treatment on a 5-point scale ranging from very dissatisfied (1) to very satisfied (5).

Dr. Geronemus presented results from 14 patients who had completed 3-month follow-up visits. These 14 women included 10 with melasma and 4 with postinflammatory hyperpigmentation. The mean age of the patients was 42 years, and 9 had Fitzpatrick skin types I-III.

The patients rated their pain as 3.25 out of 10, their overall pigment improvement as 3 out of 4, and their overall satisfaction with the procedure as a 4.33 out of 5, Dr. Geronemus reported. "This is often technique sensitive," he said of the procedure. "I’ll have physicians call me up and say, ‘I’m not getting any results.’ I think you need 10-12 passes to get the [optimal] results."

The most common side effect was erythema, which typically resolved within 1 day. Though the device is effective as monotherapy, Dr. Geronemus pointed out that it is "ideally suited for combination therapy with a mild hydroquinone."

Dr. Geronemus disclosed that he serves on the medical advisory boards for Zeltiq, Syneron/Candela, and Cynosure. He also serves as an investigator for numerous device and pharmaceutical companies, and he holds stock in Zeltiq and OnLight Sciences.

[email protected]