How to Combine Picosecond with Mesotherapy to Treat Melasma?
Melasma, as a chronic and easily recurrent acquired pigmentary skin disease, has always been a difficult treatment point in the field of skin beauty.Single therapy often fails to achieve ideal results and has a high recurrence rate. In recent years, the combined application of picosecond 1064nm laser and mesotherapy has gradually become the preferred option for treating refractory melasma. Next, we will delve into the underlying logic, operational techniques, and clinical practice points of this joint strategy.
Selection of Picosecond 1064nm Laser Treatment for Melasma
The role of picosecond 1064nm laser in the treatment of melasma has been confirmed by multiple clinical studies. Its large spot and low-energy treatment mode selectively destroys melanin particles through optomechanical effects, while avoiding the anti blackening phenomenon caused by excessive thermal damage.
A study showed that using high-energy picosecond 1064nm laser with large light spots to treat melasma, once a week for 10-20 times, the effective rate can reach 73.33% (8 cases were basically cured, 25 cases showed significant improvement, 11 cases improved, and only 1 case was ineffective). During the treatment process, the patient’s skin melanin index significantly decreased, while transdermal water loss decreased, and the skin barrier function improved.
Setting Treatment Parameters is the Key to Successfully Lose Weight
Spot size: Typically, a large spot size of 6-8mm is chosen
Energy density: Low energy range of 1.8-2.5 J/cm²
Treatment frequency: once a week, 10-15 times per course of treatment
Endpoint reaction: Mild redness in the treatment area, no epidermal splashing or punctate bleeding
It is worth noting that patients may experience mild burning pain during the treatment process and transient erythema (lasting for several tens of minutes) after surgery, which are normal treatment reactions.
Picosecond 1064nm Laser Combined with hydro-glow injection for the Treatment of Melasma
Experts discussed the effects of hydro-glow injection of sodium hyaluronate, tranexamic acid, glutathione combined with picosecond 1064nm laser on the efficacy and quality of life of patients with melasma.
Control group: Treatment with picosecond 1064nm laser. Apply compound lidocaine cream for 1 hour before treatment, and use picosecond 1064nm laser therapy. Choose a frequency of 5-10Hz, a spot diameter of 6-8mm, and a laser energy of 500-600mJ according to the patient’s lesion range (adjusted appropriately depending on the individual). The energy density gradually increases from low to high, with mild redness of the skin as the degree of intensity. Then, the treatment area is scanned at a uniform speed. For areas with severe skin lesions, the scanning can be repeated 2-3 times. After the treatment is completed, the color of the skin lesions may change slightly to red or gray white. At the end of treatment, patients were immediately given facial mask and cold sprayed distilled water for 20 minutes. Once every 4 weeks, a total of 6 times.
Research group: Sodium hyaluronate, tranexamic acid, glutathione combined with picosecond 1064nm laser therapy were injected using a hydro-glow injection device. Firstly, perform picosecond 1064nm laser treatment using the same method as above, once every 4 weeks for a total of 6 sessions. At the end of treatment, apply facial mask immediately and cold spray for 20min. After the first treatment interval of 2 weeks, the hydro-glow injection treatment was carried out. The drug was 1.5 ml of modified sodium hyaluronate for injection, 1 ml of tranexamic acid injection, and 0.6 g of reduced glutathione injection. Before treatment, compound lidocaine cream was applied for 1 hour. According to the thickness of the patient’s epidermis and the location of the skin lesions, the injection depth was adjusted to about 1 m. It was appropriate to apply and repair the facial mask after the treatment. After the interval of 2 weeks, the second laser treatment was carried out. The laser treatment and hydro-glow injection treatment were alternately carried out. The hydro-glow injection treatment was carried out once every 4 weeks, a total of 6 times.
The results showed that after 6 months of treatment, the total effective rate of the study group was 80.00%, significantly higher than the control group’s 57.89%. After 1 year of treatment, there was no recurrence in the study group, while there were 6 cases of recurrence in the control group, with a recurrence rate of 10.53% (6/57). The recurrence rate of the study group was lower than that of the control group.
Analysis of the Principle of hydro-glow injection Therapy for Melasma
Hydro-glow injection to the superficial dermis can cause damage, stimulate natural skin repair, enhance skin cell metabolism, and improve blood circulation. After picosecond 1064nm laser treatment, hydro-glow injection is applied to deliver a cocktail of sodium hyaluronate, tranexamic acid, and glutathione into the skin. Sodium hyaluronate is the main nutrient molecule in the dermis layer of the skin. On the one hand, it can improve skin microcirculation and nutrient absorption, with good moisturizing effect, reduce skin wrinkle formation, and delay skin aging.
On the other hand, it can promote the proliferation and differentiation of epidermal cells, and facilitate the repair and growth of damaged superficial dermal cells. Tranexamic acid has the effects of removing spots and whitening, and can be taken orally to treat melasma. However, considering the long course of treatment and the difficulty for patients to persist, they switched to water light injection of tranexamic acid. Clinical practice has also found that compared to oral administration, doctors using hydro-glow injection of tranexamic acid have better patient compliance and tolerance. Glutathione has antioxidant and stain reducing effects, and is also suitable for hydro-glow injection therapy. Therefore, the combination of picosecond 1064nm laser therapy and hydro-glow injection therapy has a synergistic effect, which can significantly improve the efficacy and reduce the recurrence rate.
Precautions and Long term Management
Long term management of melasma is crucial, and even after achieving satisfactory results, it is still necessary to maintain treatment:
Perform maintenance therapy once a quarter (alternating between laser or mesodermal therapy);
Strictly avoid triggering factors such as birth control pills, phototoxic drugs, and staying up late;
Continuous use of whitening and repairing products: use skincare products containing vitamin E and niacinamide in the morning and evening;
Lifestyle regulation: Ensure 7 hours of sleep and supplement foods rich in vitamin C such as kiwifruit and tomatoes.
Skin testing should be performed before treating mesotherapy to avoid use on damaged or injured skin. During treatment, avoid strong sun exposure and wash your face with a mild cleanser. If there is inflammation or sensitivity in the skin, treatment should be postponed.
The contraindications for combination therapy include active infections (such as herpes), scar constitution, coagulation dysfunction, pregnancy and lactation, allergies to the drug ingredients used, and active autoimmune diseases.
