The Prevalence and Treatment Options of Melasma as Well as its Association with Quality of Life in Darker Skin Types: A Scoping Review Protocol

BackgroundMelasma is one of the most encountered dermatoses in dermatology and skin care clinics. It is a challenging chronic, recurrent condition associated with hyperpigmentation. Its etiology is poorly understood. Melasma affects all races and gender but is more prevalent in women with darker skin types. Being a facial lesion, melasma has a severe impact on quality of life due to its disfigurement. While many modalities of treatment for melasma exists, unfortunately, effectiveness and safety remain a huge concern. Treatment modalities are variable and often unsatisfactory. The objective of this scoping review is to systemically map available evidence from literature regarding melasma, garner insight as to how melasma affects the quality of life and begin to investigate and gain understanding on effectiveness of different treatments used for melasma.MethodsA scoping review guided by Arksey and O’Malley’s framework, the enhancements and recommendations of Levac, Colquhoun and O’Brien, Daudt and associates and the 2015 Johanna Briggs Institute’s guidelines will be conducted. Systematic electronic searches of databases and search engines such as, Scopus, PubMed, CINAHL Complete, Cochrane, Science Direct, and Web of Science will be conducted to attain published peer-reviewed articles of all study designs excluding reviews. All literature that meets the inclusion criteria, research question and sub-question will be included in this review. All the retrieved literature will be exported to an Endnote X20 library. Quality appraisal of the included articles will be conducted using the mixed methods appraisal tool (MMAT) 2018 version.DiscussionWe anticipate mapping relevant literature on the prevalence of melasma, investigating the effectiveness of treatment options of melasma as well as evaluating its association with quality of life in darker skin types. This study is likely to reveal research gaps, which could guide future implementation research on melasma treatment interventions.Protocol registration: This protocol has been registered apriori with OSF and is accessible on this link: https://osf.io/ru3jc/

1927 nm Thulium Laser Successfully Treats PostInflammatory Hyperpigmentation in Skin of Color

Background. Treatment of postinflammatory hyperpigmentation (PIH) in patients with dark skin is challenging as the treatment itself might provoke paradoxical PIH. Only few studies examined the safety and efficacy of nonablative laser treatment in these patients. The objective was to examine efficacy and safety of nonablative 1927 nm wavelength laser followed by bleaching creams in the treatment of PIH. Methods. It was a prospective interventional pilot study that was conducted during 2019. All patients were of Fitzpatrick skin type IV who had unsatisfactory response to topical bleaching creams used for at least three months. Patients received one to four sessions of laser treatment (6 weeks apart) followed by topical hydroquinone 4% cream twice daily for 6 weeks. Improvement was assessed by two blinded independent dermatologist evaluators. Results. A total of nine patients were enrolled and the outcome could not be assessed in one patient who was lost for follow-up. The affected sites were the abdomen, face, and other body parts. Three of the eight evaluated patients had excellent response (37.5%), four had satisfactory response (50.0%), and one had nonsatisfactory response (12.5%). The downtime was manifested as edema and erythema that disappeared after 5 to 7 days. Improvement was more evident in first session and it declined in subsequent sessions. None of the patients had paradoxical pigmentation after treatment. Conclusions. Low energy low density nonablative fractional 1927 nm wavelength laser treatment followed by topical hydroquinone 4% cream for 6 weeks is a safe and effective modality for improving PIH in patients with darker skin types.

Pigmentation disorders: types, aetiology and treatment options

Hyperpigmentation is a chronic skin disorder that can be very difficult to treat. Skin pigmentation disorders are commonly seen in women than in men, due to hormonal factors, and in those with darker skin types. Pigmentation disorders can cause significant stress for patients and can have a detrimental effect on their quality of life; it is therefore important that aesthetic practitioners have a sound understanding of the different types of hyperpigmentation and appropriate treatments. This article will explore pigmentation disorders and how they can be treated in aesthetic practice.