Melasma Treatment

Researches » Melasma Treatment




Dermabrasion: A Curative Treatment for Melasma


Melasma, another condition characterized by skin pigmentation, is also a common concern among Asians and those with dark skin tone. Though the most common cause of the condition is quite unknown, pregnancy and birth control pills had been known to trigger the eruption of this pigmentation condition. Genetic predisposition is also one factor that dermatologists look up for Melasma.

For years, different topical medications, creams, and laser treatments had been tried for Melasma, but none of which had seen positive permanent results. For the topical creams, the pigmentation comes back soon after patients stop applying while for laser, the pigmentation still comes back after a few months.

In this study, the researchers evaluated patients with melasma who had been treated woth mechanical dermabrasion from 1988 to 1998. Five hundred and thirty three (533) patients aged 31-58 years with a mean of 42 years were included in the study. The subjects all have dermal and epidermal melasma and had been treated with dermabrasion. All subjects had Fizpatrick Type 3-5 Skin tone and indications for their dermabrasion procedure were (1) failed previous treatments, (2) recurrence after initial response to previous treatments, (3) unwillingness to comply with a prolonged course of medical treatments, (4) allergy to topical agents, (5) ochronosis, and (6) melasma with simultaneous acne scar.

The dermabrasion technique used in the study made use of the cable-driven dental motor roller unit machine that has a capability of driving a dermabrasion fraise at a maximum speed of 20,000rpm. The abrasive surface used was a 16-mm diameter coarse grit diamond fraise.

In patients with lighter skin tone, only the area involved with melasma was treated with dermabrasion, whereas, for patients with darker skin, patients were advised to have full face dermabrasion or concurrently have the uninvolved areas treated with chemical peel or CO2 laser skin resurfacing.

Immediately after dermabrasion, the treated area was rinsed thoroughly then packed for 7 days.

Follow up evaluations were scheduled every 1-2 weeks for the first 2 months, then every 1-2 months thereafter. Some patients developed hyperpigmentation or increasing hyperemia a few weeks after the procedure. This pigmentations were easily controlled by topical hydroquinone.

Of the 533 cases, only 410 were available for long term follow up. From these 410 cases, 165 (40%) developed temporary hyperpigmentation while 145 (35%) developed hyperemia. At a mean follow up of 5 years, 398 of the 410 (97%) achieved persistent clearance of melasma without recurrence. The remaining 3% experienced partial recurrence after initial clearing. Complications were encountered in 3 cases (0.7%): 2 with hypertrophic scar, 1 on the upper lip and 1 on the mandibular plane jaw line; and another subject developed permanent hypopigmentation on the forhead.


See paper abstract here.

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