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Background: Postinflammatory hyperpigmentation (PIH) is the most common skin complication in Asians after invasive cosmetic treatments., Objective: To determine whether oral tranexamic acid (TA) reduces the incidence of PIH after Q-switched ruby laser (QSRL) treatment., Methods and Materials: Thirty-two Japanese women underwent QSRL treatment for senile lentigines on the face. They were randomly divided into two groups that did (n=15) and did not (n=17) receive oral TA treatment (750 mg/d) for the first 4 weeks after QSRL treatment. Nineteen participants had melasma-like maculae at baseline. Clinical and colorimetric assessments were performed at baseline and 2 and 4 weeks later., Results: Pigmentation was effectively treated using QSRL at 2 weeks, but PIH was frequently seen at 4 weeks. There was no significant difference in the incidence of PIH between participants who received oral TA and those who did not. The presence of melasma did not influence the effectiveness of the treatment., Conclusion: Although oral TA has been reported to have depigmentation effects, it may not be effective for preventing PIH after QSRL. Considering the dosage and duration of treatment, an optimal protocol may be needed to induce the efficacy of this treatment to achieve the PIH-preventing effect of oral TA., (© 2011 by the American Society for Dermatologic Surgery, Inc.)

"Thermie" therapy is one of the folk remedies in Japan and is mainly done by rubbing the skin with special instruments. The therapy is believed to relieve several symptoms which include pain, common cold and ileus. We report here the first two cases of thermie dermatosis in the English published work. The first patient had suffered from poikiloderma-like eruptions for 30 years after the initiation of a thermie therapy. The eruptions were on both the upper back and the abdomen. The second patient presented with a hyperpigmented plaque on the right femoral region, and excoriated papules and a hyperpigmented plaque on the left lower leg. The patient had received thermie therapy for 3 years. The histopathology of the first case revealed features of cutaneous amyloidosis, and, of the second case, superficial dermatitis and hypermelanosis in the epidermal basal layer. A common cause of both cases was regarded as the thermie therapy. This report suggests the importance of getting a thorough history including folk remedies in patients presenting such pigmented lesions.

Facial linear scars with concave and erythematous appearance sometimes occur after long observation even if adequate conservative treatments have been applied. Because the regenerated epithelium is thin, those scars are seen as red or pink, and are sometimes accompanied with postinflammatory hyperpigmentation. For these scars, flashlamp-pumped pulsed dye of the wavelength of 585 nm and pulse-width of 450 micro s was used, and acceptable results were obtained. Three cases required one treatment and one case needed two, and any side effects were not recognized. Compared with the carbon dioxide laser, which often shows severe scarring as a side effect, the pulsed dye laser with a short down time is useful.