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Non-invasive high-intensity focused ultrasound for UV-induced hyperpigmentation in Fitzpatrick skin types III and IV: a prospective, randomized, controlled, evaluator-blinded trial

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Abstract

Skin hyperpigmentation is a frequently encountered problem, particularly in darker skin types. Unfortunately, standard treatments for this condition have shown disappointing results. High-intensity focused ultrasound (HIFU) is commonly indicated for skin laxity, but recently was used to treat UV-induced hyperpigmentation in animal models. This study is aimed to evaluate the efficacy and safety of high-intensity focused ultrasound for UVB-induced hyperpigmentation in human subjects. A randomized, evaluator-blinded pilot study was conducted on 20 subjects. Each subject was induced three hyperpigmentary spots by local broadband UVB. After 2 weeks, each spot was randomly allocated to control, low-energy, and high-energy HIFU. Subjects were instructed to follow up weekly for a duration of 1 month. Lightness index measurements, mean improvement scores, subjects’ satisfaction, pain scores, and side effects were evaluated. All 20 subjects completed the study. Fourteen subjects had Fitzpatrick (FPT) skin type III and six subjects had FPT skin type IV. Twelve subjects showed greater improvement at control sites while eight subjects showed greater improvement at HIFU-treated sites. In FPT skin type III, HIFU appeared to be inferior to control in both lightness index and mean improvement scores, but in FPT skin type IV, HIFU had greater lightness index improvement and higher improvement scores than control. Side effects were more frequent in high-energy-treated areas. Focused ultrasound may be offered in some patients with hyperpigmentary conditions. More research is needed to determine proper energy settings for optimal outcome.

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Acknowledgements

We thank Dr. Suthinee Rutnin for her help in histopathological evaluation.

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Authors and Affiliations

  1. Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI road, Rajthevi, Bangkok, 10400, Thailand

    Vasanop Vachiramon, Natthachat Jurairattanaporn, Sarawin Harnchoowong & Pamela Chayavichitsilp

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  1. Vasanop Vachiramon
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  2. Natthachat Jurairattanaporn
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  3. Sarawin Harnchoowong
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  4. Pamela Chayavichitsilp
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Corresponding author

Correspondence to Vasanop Vachiramon.

Ethics declarations

This study has been approved by Mahidol University Institutional Review board for Human Subject Research (protocol number 125910). The study protocol followed the guidelines of the 1964 Helsinki declaration. All patients signed informed consent before participating in the study.

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The authors declare that they have no conflict of interest.

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Vachiramon, V., Jurairattanaporn, N., Harnchoowong, S. et al. Non-invasive high-intensity focused ultrasound for UV-induced hyperpigmentation in Fitzpatrick skin types III and IV: a prospective, randomized, controlled, evaluator-blinded trial. Lasers Med Sci 33, 361–367 (2018). https://doi.org/10.1007/s10103-017-2393-5

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  • DOI: https://doi.org/10.1007/s10103-017-2393-5

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