Chemical and biostimulant peel with biphasic technology to treat melasma, followed by combined treatments for facial rejuvenation and lifting effect

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Enrico Massidda


Melasma, Chemical Peeling, Biostimulation


Melasma is a pigmentation disorder of the skin mostly affecting women, especially those with darker skin. It is commonly seen on the face and appears as dark spots and patches with irregular borders. Melasma happens because of an overproduction of the cells that cause skin to have its color. It is harmless, but not easy to treat and present satisfying results. The patient in question was treated for two years every 15 days with a chemical peeling with a biphasic technology. The active ingredients’ dermo-functionality contributed to a profound stimulation of skin replication and biosynthetic processes, essential to counterbalance the effects of skin pigmentation, aging and oxidative damage. During the peeling sessions, treatments with reabsorbable traction threads, with calcium hydroxyapatite (CaHA) filler, with hyaluronic acid filler and with botulinum toxin were performed to reduce skin laxity and increase collagen for skin rejuvenation.

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1. Artzi O, Horovitz T, Bar-Ilan E, et al. The pathogenesis of melasma and implications for treatment. J Cosmet Dermatol. 2021; 20(11): 3432-3445.
2. Plensdorf S, Livieratos M, Dada N. Pigmentation Disorders: Diagnosis and Management. Am Fam Physician. 2017; 96(12):797-804.
3. Kagha K, Fabi S, Goldman MP. Melasma’s Impact on Quality of Life. J Drugs Dermatol. 2020; 19(2):184-187.
4. Austin E, Nguyen JK, Jagdeo J. Topical Treatments for Melasma: A Systematic Review of Randomized Controlled Trials. J Drugs Dermatol. 2019; 18(11): S1545961619P1156X.
5. Khalili M, Amiri R, Iranmanesh B, Zartab H, Aflatoonian M. Safety and efficacy of mesotherapy in the treatment of melasma: A review article. J Cosmet Dermatol. 2022; 21(1):118-129.
6. Lee YS, Lee YJ, Lee JM, Han TY, Lee JH, Choi JE. The Low-Fluence Q-Switched Nd:YAG Laser Treatment for Melasma: A Systematic Review. Medicina (Kaunas). 2022; 58(7):936.
7. Conforti C, Zalaudek I, Vezzoni R, et al. Chemical peeling for acne and melasma: current knowledge and innovations. G Ital Dermatol Venereol. 2020; 155(3):280-285.
8. Lee AY. Skin Pigmentation Abnormalities and Their Possible Relationship with Skin Aging. Int J Mol Sci. 2021; 22(7):3727.
9. Fischer T, Perosino E, Poli F, Viera M, Dreno B, Cosmetic Dermatology European Expert Group. Chemical peels in aesthetic dermatology: an update 2009. J Eur Acad Dermatol Venereol. 2010; 24(3):281–292.
10. Matarasso SL, Salman SM, Glogau RG, Rogers GS. The role of chemical peeling in the treatment of photodamaged skin. J Dermatol Surg Oncol. 1990; 16(10):945–954.
11. Vincent Wong. The Science of Absorbable Poly(L-Lactide-Co-ε-Caprolactone) Threads for Soft Tissue Repositioning of the Face: An Evidence-Based Evaluation of Their Physical Properties and Clinical Application. Clin Cosmet Investig Dermatol. 2021; 14:45-54.
12. Massidda E. Starting Point for Protocols on the Use of Hyperdiluted Calcium Hydroxylapatite (Radiesse®) for Optimizing Age-Related Biostimulation and Rejuvenation of Face, Neck, Décolletage and Hands: A Case Series Report. Clin Cosmet Investig Dermatol. 2023; 16:3427-3439.
13. Cassuto D, Bellia G, Schiraldi C. An Overview of Soft Tissue Fillers for Cosmetic Dermatology: From Filling to Regenerative Medicine. Clin Cosmet Investig Dermatol. 2021; 14:1857-1866.
14. Choudhury S, Baker MR, Chatterjee S, Kumar H. Botulinum Toxin: An Update on Pharmacology and Newer Products in Development. Toxins (Basel). 2021; 13(1):58.