Treatment strategy of melasma & positioning of laser toning

Melasma is made up of many component factors. so it is considered a syndrome. Therefore, avoidance of possible causes for this syndrome, e. g., ultraviolet light and physical irritation, is important. Oral tranexamic acid, which suppresses melanocyte stimulation caused by various factors, is effective for melasma and is considered the treatment of choice. To diagnose melasma, the skin is examined by ultraviolet microscopy and the state of the skin, such as the stratum corneum as the skin barrier and/or the presence of hypo-pigmentation, is examined. Oral tranexamic acid is the suggested treatment and is usually administered for two months. After this treatment and once a barrier function disorder is ruled out, laser toning treatment is administered. Laser toning is administered approximately eight times in two months, every one or two weeks. Monitoring hypo-pigmentation by ultraviolet microscopy at each appointment helps determine the efficacy of the treatment. Once pigmentation is improved, treatment can be changed to a more conservative method. If laser therapy is chosen to be continued, the intervals between treatment periods can be extended to at least one month. The effectiveness of laser toning treatment for melasma is unknown and needs to be tested further. For example, the interval between treatments, the number of treatments, and the optimal laser output to use still need to be determined. In conclusion, it is important to keep skin in a healthy condition and to treat melasma gradually. Melasma should not be treated in a short period of time, as is always a risk of hypo-pigmentation, which can be a fatal complication of excessive treatment.