Clinicopathologic Efficacy of Copper Bromide Plus/Yellow Laser (578 nm with 511 nm) for Treatment of Melasma in Asian Patients

BACKGROUND: Melasma is a common pigmentary disorder in Asians. Although the pathogenesis of melasma is not yet fully understood, there are several hypotheses supporting angiogenetic factors related to some types of melasma. OBJECTIVE: To test the efficacy of copper bromide laser in the treatment of Korean women with melasma. MATERIALS AND METHODS: Clinical parameters included physician and patient assessment and Melasma Area and Severity Index score. The intensity of pigmentation and erythema was measured using a chromometer. To evaluate histopathologic changes, punch biopsies from melasma were obtained from four patients. Immunohistochemical staining for Melan-A, endothelin 1, CD34, and vascular endothelial growth factor (VEGF) antigen of the melasma lesions was observed. RESULTS: Mean MASI score decreased dramatically after treatment. Patients exhibited telangiectatic erythema within the melasma lesion. The values of L(*) reflecting intensity of pigmentation increased, and the values of a(*) as the measurement of redness decreased after the treatments. Expression of Melan-A, CD34, endothelin-1, and VEGF decreased after treatment. CONCLUSION: The potential application of an antiangiogenetic laser for the treatment of melasma specially accompanied by pronounced telangiectasia in Asian skin is a possible treatment option.