Study of Laser Treatment of Melasma

Recruitment & Eligibility

Inclusion Criteria

Fitzpatrick Skin Type III-VI
mixed (epidermal and dermal) melasma diagnosed by Wood's Lamp exam
age 18 or older
melasma persisting for greater than 6 months that has failed to respond to conventional treatment with hydroquinone or other topical lightening agents
written and verbal informed consent
willing and able to comply with study instructions and return to the clinic for required visits

Exclusion Criteria

Pregnancy, breastfeeding, taking birth control pills or plans to become pregnant during the study
history of cutaneous photosensitization, porphyria, and hypersensitivity to porphyrins or photodermatosis
any skin pathology or condition that could interfere with the evaluation or requires the use of interfering topical or systemic therapy
uncorrected coagulation defect or is currently using anti-coagulation medication (including but not limited to heavy aspirin therapy)
any condition which, in the investigator's opinion, would make it unsafe for the subject to participate in this research study
currently enrolled in an investigational drug or device trial, or has received an investigational drug or has been treated with an investigational device within 30 days prior to entering this study
inability to communicate or cooperate with the investigator due to language problems, poor mental development, or impaired cerebral function
unreliability for the study (this includes subjects who engage in excessive alcohol intake or drug abuse, or subjects who are unable to return for scheduled follow-up visits)
use of photosensitizing drugs within a timeframe where photosensitization from these drugs may still be present
need to be exposed to artificial tanning devices or excessive sunlight during the trial
Diabetes Type I or II
sensitivity to hydroquinone or Retin-A
evidence of a compromised immune system or hepatitis
use of bleaching creams or retinoids within the last 30 days

Arm && Interventions

Group	Intervention	Description
Laser treatment	Retin-A and microdermabrasion	Laser treatment and microdermabrasion and topical lightening agent regimen
Control	Retin-A and microdermabrasion	Microdermabrasion and topical lightening agent regimen

Primary Outcome Measures

Name	Time	Method
Melasma Area Severity Assessment (MASI) Score Change From Baseline to Follow Up	3 Months	The severity of the melasma is assessed based on a photographic scale. The scale ranges from 0 to 48, with 48 being the most severe. A decrease in the MASI score from the baseline to the follow up corresponds with decreasing severity.

Secondary Outcome Measures