Comparative study of the use of exogenous pigmentation as an adjuvant therapy to Intense Pulsed Light in the treatment of melanoses on the dorsum of the hands

Introduction: The use of exogenous pigmentation as an adjuvant therapy to Intense Pulsed Light in the treatment of melanoses is routine, nevertheless there is an absence of published comparative studies. Objective: To compare Intense Pulsed Light therapy in isolation, or combined with exogenous pigmentation in the treatment of solar lentigines on the dorsum of the hands. Methods: Twenty women (mean age = 56.5 years) with skin types from I to III, underwent three sessions of Intense Pulsed Light, with a brown makeup pencil pigment reinforcement being applied to the lesions on the right hand. The patients were queried about the degree of discomfort, swelling, crusting, and improvement experienced, their treatment of preference and which they felt provided greater effectiveness, and the incidence of side effects. Results: When assessing all three of the treatment sessions together, the median discomfort score, as well as the degree of inflammation and crusting (p < 0.01), were higher on the right hand. Regarding the subjective impression of the final result, 15 in 20 patients preferred the technique applied on the right hand, considering it more effective (p < 0.01). Eleven in 20 patients reported fewer side effects in the un-pigmented side (p = 0.12). The degree of discomfort did not correlate significantly with the preferred technique (p = 0.67). Conclusions: In this sample, there was a preference for the method with the adjuvant use of exogenous pigmentation, however the incidence of pain and side effects was higher in this group.

Keywords: MELANOSIS, HAND, PIGMENTATION, LIGHT