Background: Q-switched laser treatment for pigment disorders commonly leads to postinflammatory hyperpigmentation (PIH) in Asians. Objectives: To evaluate the effect of spot size and fluence on Q-switched alexandrite laser (QSAL) treatment for pigmentation in Asians. Methods: Ten patients with freckles, 18 with lentigines, and 8 with acquired bilateral nevus of Ota-like macules (ABNOM) received 1 session of QSAL treatment for a 3-mm spot on one cheek and a 4-mm spot on the other cheek. The lowest fluences to achieve a visible biologic effect were chosen. Results: The patients with freckles experienced the highest improvement rate (83–84%), followed by those with lentigines (52%) and ABNOM (35%). Similar efficacy was observed for both cheeks (p > 0.05). PIH developed in 10% (1/10), 44% (8/18), and 75% (6/8) of the patients with freckles, lentigines, and ABNOM, respectively. The severity of PIH was lower in the 4-mm spot with a lower fluence than in the 3-mm spot with a higher fluence in patients with lentigines (p = 0.03), but not in those with freckles or ABNOM. Conclusions: Using a larger spot to achieve the same biologic effect at a lower fluence is associated with equal efficacy and less-severe PIH in patients with lentigines.

Atopic dermatitis (eczema) is a condition that makes skin red and itchy. Though common in children, the condition can occur at any age. Atopic dermatitis is persistent (chronic) and tends to recur periodically. It may be accompanied by asthma or hay fever. No cure has been found for eczema. Therefore, it is very important to develop ingredients that aid the prevention and treatment of atopic dermatitis. Cycloheterophyllin is derived from Artocarpus heterophyllus and has antioxidant and anti-inflammatory activities. However, it still is not understood whether cycloheterophyllin is an anti-atopic dermatitis agent. Keratinocytes (HaCaT cells) and BALB/c mice for inducing AD-like cutaneous lesions were used to evaluate the potential of cycloheterophyllin as an anti-atopic dermatitis agent. The release of pro-inflammatory cytokines induced by treatment of TNF-α/IFN-γ was reduced after pretreatment with cycloheterophyllin. The inhibitory effects could be a contribution from the effect of the MAP kinases pathway. Moreover, the symptoms of atopic dermatitis (such as red skin and itching) were attenuated by pretreatment with cycloheterophyllin. Epidermal hyperplasia and mast cell infiltration were decreased in the histological section. Finally, damage to the skin barrier was also found to recover through assessment of transepidermal water loss. Taken together, prenylflavone-cycloheterophyllin from Artocarpus heterophyllus is a potential anti-atopic dermatitis ingredient that can be used in preventing or treating the condition.