Melasma treatment with pulsed-dye laser and triple combination cream: a prospective, randomized, single-blind, split-face study.

R ecent data show that melasma lesions have, in addition to increased pigmentation, more elastosis and vascularization than perilesional skin. The stabilized formulation of Kligman preparation has shown significant improvements in the treatment of melasma. However, most of the treatments only target the pigmentation, and none of them has been demonstrated so far to prevent the frequent relapses. Pulsed-dye laser treatment (PDL) is considered the gold standard therapy for vascular lesions. By targeting not only melanin but also vascularization and at least in part elastosis, PDL might provide, in combination with blanching cream, an effective and complete therapeutic approach for melasma. The objective of this pilot study was to evaluate the dual treatment of fixed triple combination cream (TCC) and PDL in the treatment of melasma.