Original Investigation

In Vivo Evaluation of Melasma Pathologic Features and Treatment Response by 2-Photon Microscopy

JAMA Dermatology 10.1001/jamadermatol.2025.2790

August 13, 2025 at 11:00 AM EDT

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What is the clinical value of 2-photon microscopy (TPM) for melasma?In this observational study involving 60 participants with melasma, TPM-based 3-dimensional imaging of 120 lesional and perilesional areas revealed 7 significant pathologic features associated with the condition. In addition, in a subset of 53 participants who completed a 12-week treatment with hydroquinone cream, 2%, follow-up TPM analysis demonstrated statistically significant reductions in epidermal melanin content and activated melanocyte numbers after treatment.TPM represents a promising noninvasive skin imaging tool for in vivo histopathologic evaluation and cellular-level therapeutic monitoring in melasma.

Corresponding Authors: Yong Cui, PhD (wuhucuiyong@vip.163.com), Xianbo Zuo, PhD (zuoxianbo@qq.com), and Jingkai Xu, PhD (jkaixu1992@163.com), Department of Dermatology, China-Japan Friendship Hospital, No. 2 Yinghua East St, Beijing 100029, China.

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