INTRODUCTION: Melasma is a highly common dermatosis that has numerous therapeutic alternatives but tends to be a therapeutic challenge due to its refractory and relapsing nature.
OBJECTIVE: Comparison between intense pulsed light with pulse-in-pulse mode (IPL-PIP) and retinoic acid peel (RAP) for melasma treatment.
METHODS: We conducted six bi-weekly IPL-PIP sessions in the left hemiface and three-monthly RAP sessions in the right hemiface.The Melasma Area and Severity Index (MASI) and MelasQol questionnaires were applied before and one month after the last treatment session.
RESULTS: We observed a reduction of approximately 33% in hemiface MASI with RAP and of 35% in hemiface with IPL-PIP, showing significant improvement of melasma with both methods.There was no statistically significant difference between the two groups. Both practices were well tolerated by patients, but RAP had more reports of adverse events than IPL-PIP.There was a substantial improvement in the quality of life of the patients with both therapeutic methods.
CONCLUSIONS: RAP and IPL-PIP are effective in treating melasma and improving patients' quality of life.There was no statistical difference between the methods concerning lesion clearance and quality of life of patients.

Keywords: Chemexfoliation; Light; Melanosis; Retinoids

INTRODUCTION: Keloids are known to impact the quality of life of their patients. Intralesional corticosteroid injection (ICI) is still the most widely used therapeutic option, although with variable results and limitations. Numerous other strategies have been studied, including the association of lasers with drug delivery (DD).
OBJECTIVES: To compare the therapeutic response between ICI with isolated triamcinolone acetonide and the association of ablative fractional laser (AFL) and DD of the same drug, and assess quality of life.
METHODS: We followed-up eight keloid patients who underwent three sessions with a one-month interval between them. ICI was performed in the right half of the scar and AFL and DD on the left. In assessing the results studied statistically, we used measurement and clinical and photographic comparison of the lesions, the Vancouver clinical and analog pain scales, and the Dermatology Life Quality Index questionnaire.
RESULTS: We observed a statistically significant improvement in keloids with both techniques. In comparison, ICI was significantly higher than the AFL with DD. On the other hand, the latter technique was statistically less painful. As for patients' quality of life, a significant improvement was observed after treatment in both cases.
CONCLUSIONS: Both methods were significantly effective in improving keloids; however, ICI showed to be superior. AFL with DD was better tolerated than ICI and is an interesting option for patients with extensive lesions or low pain tolerance.

Keywords: Drug delivery systems; Injections, Intralesional; Keloid; Lasers; Triamcinolone acetonide