Successful Treatment of Refractory Melasma Using Invasive Micro-Pulsed Electric Signal Device

Abstract

Treatment of facial melasma refractory to low-fluence Q-switched Nd:YAG laser (LFQSNY) and topical lightening agents (TLA) is a challenge. The objective of this study was to investigate the safety and efficacy of an additional invasive micro-pulsed electric signal device (IMPES) for treatment of melasma refractory to LFQSNY/TLA. Five female patients (Fitzpatrick skin type III–IV) with refractory facial melasma were treated using IMPES added to their baseline of LFQSNY/TLA treatment. Four to seven treatments were administered at 1-week intervals. The power levels ranged from 3 to 5, depth 1.2 mm to 1.7 mm, and single pass. Photographs were taken at the beginning and 1 week after the last treatment. At the last treatment, assessments showed greater than 50% clinical improvement in melasma in all five patients. Follow-up interviews were conducted at the 8th week. No recurrence was reported during the follow-up at 8 weeks. No significant adverse effects were noted. Addition of IMPES to LFQSNY/TLA is a safe and effective treatment for refractory melasma.