Intense pulsed light (IPL) has been successfully used in refractory melasma in Asians, and has been found to be more useful than pigment-specific lasers in severe cases of melasma. It is also an excellent laser for treating lentigenes associated with photoaging (61). In a study of 33 Asian women with refractory dermal or refractory mixed melasma, the combination of IPL with 4% hydroquinone for one month was more effective than hydroquinone alone. Objective measurements were used to evaluate the skin lightening effect. A 39.8% improvement in relative melanin index was seen in the combination treatment group, versus 11.6% in the hydroquinone group at week 16 (p<0.05). Four treatments were done at one-month intervals. Two patients in the IPL group experienced PIH. Partial transient repigmentation was noted 24 weeks after the last treatment session in two patients (62). IPL has also proven effective in the treatment of freckles in Asian patients (61) and in disfiguring lentigines associated with Peutz-Jeghers syndrome (63,64).
Intense pulse light can be safely used in dark skinned people with dermal hyperpigmentation.