Melasma is a common pigmented disease of the face, which can involve 40% of women and 20% of men in Asian population. Due to the poor effect of traditional therapies (sunscreen, depigmentation agent, dermabrasion, chemical peeling, etc.), more and more people try to use laser treatment for melasma in recent years. We applied the new E light therapy instrument to treat 40 cases of melasma patients and achieved satisfactory results, which are reported as follows.
1. Clinical data and methods
1.1 General data All patients were from our dermatology outpatient clinic, 40 cases in total, and all met the clinical diagnostic criteria of melasma [1]. The age ranged from 25 to 42 years old, with an average of 34.4 years; the disease duration ranged from 2 months to 13 years, with an average of 3.6 years, and the lesions were mainly concentrated on the cheeks, cheek, temporal and frontal areas, showing light brown, brown and dark brown under natural light.
1.2 Exclusion criteria
①People who had used depigmentation agents and internal vitamin and photosensitive drugs within 1 month;
②Pregnant or lactating women, scar system and various facial dermatitis (especially solar dermatitis);
③Patients with combined liver, cardiovascular disease, diabetes, malignant tumor and severe liver and kidney function impairment;
④Exclude other pigmentary diseases of the face;
⑤ Those who are ready to receive sunbathing within 1 month [2].
1.3 Treatment method
HONKONE light therapy instrument was used, wavelength 530-1200 nm, number of pulses 5, pulse width 2.9-3.3 ms, pulse interval 3-5 ms, energy density 25-40 J/cm2, RF energy 15-19 J/cm2. operation method: file was established before treatment, photographs were taken, patients’ faces were cleaned with warm water and then 1-3 mm thick cold gel was applied evenly on their faces. Special eye shields cover both eyes, the E light treatment head and cold gel gently contact, irradiation, starting with low energy from the bottom up, from the outside to the inside of the treatment, until the patient’s skin appears obvious prickly heat and observed local skin slightly red for the degree, after the end of treatment, wash out the gel. The operator records the treatment parameters and the skin condition during the procedure, and instructs the patient to avoid light and photosensitive foods and medications after the procedure. The patient was treated once every 4 weeks for a total of 4 times.
1.4 Judgment standard of efficacy
Cured: pigmented patches completely disappeared or the receding area was >90%; effective: pigmented patches receded > 60% or there were normal skin islands in the pigmented patches; effective: pigmented patches receded > 30% or pigmented patches became lighter; ineffective: pigmented patches did not recede significantly [1].
2, Results
2.1 Treatment results.
Forty patients were observed in follow-up after 4 times of treatment, 5 cases were basically cured, 23 cases were significantly effective, 9 cases were effective, and 3 cases were ineffective, with a total efficiency of 70%. The patients’ facial pigmentation color became lighter or disappeared, the skin texture became smooth and meticulous, some patients’ pores were reduced, and sebaceous gland secretion was decreased.
2.2 Adverse reactions.
Patients tolerated the treatment process, among which one case showed slight facial redness after treatment, and one case showed dry skin, which lasted for several hours to several days and resolved on its own;
3. Discussion
Melasma is a kind of facial pigmentation skin disease commonly found in women. Its etiology is unclear because it is commonly found in women during pregnancy or on oral contraceptives, so it is often thought to be related to endocrine function changes. Facial hyperpigmentation may be due to the combined action of estrogen and progesterone, which stimulate melanocytes, and progesterone, which promotes the transport and diffusion of melanosomes, increasing melanin production and promoting hyperpigmentation. Recently, it has been found that the occurrence of this disease is related to microecological balance, metabolic abnormalities and poor quality cosmetics. At present, there are many treatment methods for this disease, but there is a lack of a method with precise efficacy, simplicity and low side effects.
IntensePulsedLight (IPL) is a high-intensity, non-coherent, multi-spectral light source, which produces photothermal effects that selectively damage vascular lesions and pigmented lesions without damaging the surrounding normal premise, so that the target target destruction, decomposition, superficial pigment particles, dust with the skin flakes off, deeper by phagocytes phagocytosis with the lymphatic circulation to discharge The deeper ones are swallowed by phagocytes and discharged with the lymphatic circulation, or are gradually transported away with the lymphatic circulation/blood circulation, thus achieving the efficacy of removing pigmentation [3].
At the same time, its biostimulation and heating effect on the dermal tissue causes the deep collagen fibers and elastic fibers to proliferate and rearrange, and the skin regains elasticity. Yuanhong Li et al [3] found that after four IPL treatments on melasma patients, the color of the patients’ facial patches became lighter and smaller, and the skin texture was smoother and more delicate than before. The skin L-value increased significantly; 78.9% of the patients obtained more than 50% improvement; 71.1% of the patients considered the treatment effect satisfactory or very satisfactory, and the side effects were mild. E light technology is a new treatment technology combining intense pulsed light (IPL) with bipolar RF energy, which uses the selective absorption of light energy by the skin to cause the impedance difference between the target tissue and normal skin, and strengthens the absorption of RF energy by the target tissue at a lower intensity of light energy, which greatly eliminates the possible side effects and discomfort caused by the excessive thermal effect of light energy [4]. The side effects and discomfort that may be caused by the excessive thermal effect of light energy are greatly eliminated [4].
Compared with intense pulsed light, E light is more comfortable, has fewer side effects, and is more easily accepted by patients. Accordingly, we treated 40 cases of melasma with E light, and 5 cases were cured, 23 cases were effective, 9 cases were effective, and 3 cases were ineffective, with a total efficiency of 70%. The facial pigmentation of patients became lighter or even disappeared, and the texture of facial skin became smooth and delicate, and the pores of some patients were reduced, and the secretion of sebaceous glands was decreased. At the same time, it can also improve the glossiness of the skin, improve fine wrinkles, tighten the skin and remove superficial vascular lesions to achieve the cosmetic purpose of comprehensive improvement, and most patients are very satisfied with the treatment effect. In conclusion, E light treatment for female melasma is reliable, with little damage to tissues and few adverse reactions, easy to operate, and worthy of clinical application.