Combination treatment of melasma with intense pulsed light and biorevitalization injections of trehalose and hyaluronic acid

Introduction. The pathogenesis of melasma is multifactorial, involving a complex interplay of various factors, including damage to the basement membrane, disrupted autophagy, oxidative stress, and vascularization. To achieve optimal treatment outcomes, a multifaceted approach is recommended, focusing on the normalization of melanogenesis and the suppression of the primary causative factors.

Aim. To confirm the benefits of the combined use of intense pulsed light (IPL) and hyaluronic acid/trehalose injections in patients with melasma.

Materials and methods. The study involved 30 female patients aged 36–60 years diagnosed with melasma, who were divided into three study groups. Group 1 received three procedures of IPL exposure combined with intradermal administration of hyaluronic acid (1.5%) and trehalose (0.03%). Group 2 received three intradermal injections of hyaluronic acid (1.5%) and trehalose (0.03%). Group 3 received three IPL treatments without adjunctive biorevitalization. Skin condition, pigmentation, and telangiectasias were evaluated using validated clinical scales and Antera 3D skin analysis.

Results. A noteworthy finding was the observed decrease in the severity of dyschromia across all study groups. The most significant difference of IGA 1.2 was recorded in Group 1, which received a combination of IPL and biorevitalization. Groups 2 and 3 demonstrated a decrease of 0.4 and 0.2, respectively. In Group 1, the mean IGA score for telangiectasias decreased by 0.8, while Group 2 and Group 3 demonstrated a respective decrease of 0.3 and 0.6. After performing 3 procedures of combined treatment, the patients of Group 1 were more satisfied with the results of the correction performed than the patients from Groups 2 and 3. The absence of adverse events indicated that treatment methods were well tolerated and demonstrated comparable safety profiles.

Conclusion. The findings of the study corroborate the synergistic effect and safety of the combination treatment for melasma. The combination of IPL and trehalose-stabilized hyaluronic acid represents a promising method of treating melasma, with the potential to achieve high clinical efficacy while minimizing adverse effects.

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