Preliminary Evaluation of Improvements in Melasma and Photoaging With Laser-Driven Microjet Injection of Poly-d,l-Lactic Acid

BACKGROUND: Melasma, a common skin hyperpigmentation disorder, has traditionally been linked to hormonal changes in genetically predisposed individuals. Recent studies, however, highlight the role of photoageing, particularly from visible light exposure, as a significant contributing factor. Effective treatments for melasma and associated signs of photoageing remain a clinical challenge. OBJECTIVE: This study aimed to evaluate the efficacy and safety of Poly-d,l-lactic acid (PDLLA) delivered via laser-induced microjet injectors in treating melasma and signs of photoageing. PATIENTS AND METHODS: Eighteen Korean participants aged 42 to 74, with Fitzpatrick skin types III to IV, were enrolled. All participants exhibited melasma, signs of photoageing, or both. PDLLA was administered using the Mirajet device over 5 to 9 sessions. Clinical outcomes were assessed using the modified Melasma Area and Severity Index (MASI) and the Glogau Classification for photoageing. Adverse events were monitored throughout the study. RESULTS: Significant improvements were observed in both melasma severity and signs of photoageing. The mean MASI score decreased from 22.72 to 7.31 ( p =.004). Photoageing severity, as assessed by the Glogau Classification, also improved notably. Minimal side effects were reported, primarily transient bleeding. CONCLUSION: PDLLA administered via laser-induced microjet injectors appears to be a safe and effective treatment for melasma and photoageing, particularly in patients with more severe melasma. These findings suggest the potential for PDLLA in skin rejuvenation; however, further randomised controlled trials are warranted to confirm these results and optimise treatment protocols.