Laser energy triggers melanocyte hyperactivation in melasma patients, causing paradoxical darkening (post-laser PIH) that is significantly worse than the original condition
Neurochem Res 41:8695 Howard P, Twycross R, Shuster J, Mihalyo M, Rmi J, Wilcock A (2011) Anti-epileptic drugs
This produces sustained GH elevation rather than the pulsatile release that ipamorelin creates
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