An update on the safety of hydroquinone
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Cited by 3 publications
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Review of Applications of Microneedling in Melasma
BackgroundMelasma, a common skin pigmentation disease, can negatively impact patients' mental health, social interactions, and physical appearance. Although we now have several treatments accessible, such as medicines, chemical peels, and phototherapy, which can help ease symptoms to some extent, the requirement for a long‐term effective and safe treatment for patients is far from met. In the face of this problem, microneedling, as an innovative treatment, provides a new avenue for treating melasma. Although microneedling has been extensively investigated for treating other skin issues such as inflammation, scarring, and photoaging, research into its use in melasma treatment is still in its early stages.ObjectiveThis study aimed to gather and assess clinical information on microneedling's effectiveness in treating melasma, covering research gaps and serving as a beneficial reference for clinical therapy.MethodsWe searched PubMed, Cochrane, Scopus, Embase, and Web of Science databases for articles with the keywords “microneedling,” “percutaneous collagen induction”, and “melasma.” Following a thorough assessment, we selected 64 clinical studies that matched the requirements for in‐depth analysis.ResultsAfter thoroughly reviewing these data, we concluded that microneedling has tremendous potential for treating melasma. Microneedling can significantly improve treatment outcomes, especially when paired with additional therapies such as topical medicines or phototherapy.ConclusionOverall, the evidence reported in this study demonstrates that microneedling is an essential advancement in melasma treatment. Not only can it improve the efficacy of topical drugs and other treatment modalities, but it also has an excellent safety and tolerability profile, making it desirable to patients and clinicians. While the current findings are encouraging, more study is needed to refine treatment protocols, investigate the long‐term consequences of microneedling, and establish it as the standard of care for melasma treatment. We anticipate that microneedling will play an increasingly important role in the future of melasma treatment, providing our patients with more hope and a broader choice of treatment alternatives.
Review of Applications of Microneedling in Melasma
BackgroundMelasma, a common skin pigmentation disease, can negatively impact patients' mental health, social interactions, and physical appearance. Although we now have several treatments accessible, such as medicines, chemical peels, and phototherapy, which can help ease symptoms to some extent, the requirement for a long‐term effective and safe treatment for patients is far from met. In the face of this problem, microneedling, as an innovative treatment, provides a new avenue for treating melasma. Although microneedling has been extensively investigated for treating other skin issues such as inflammation, scarring, and photoaging, research into its use in melasma treatment is still in its early stages.ObjectiveThis study aimed to gather and assess clinical information on microneedling's effectiveness in treating melasma, covering research gaps and serving as a beneficial reference for clinical therapy.MethodsWe searched PubMed, Cochrane, Scopus, Embase, and Web of Science databases for articles with the keywords “microneedling,” “percutaneous collagen induction”, and “melasma.” Following a thorough assessment, we selected 64 clinical studies that matched the requirements for in‐depth analysis.ResultsAfter thoroughly reviewing these data, we concluded that microneedling has tremendous potential for treating melasma. Microneedling can significantly improve treatment outcomes, especially when paired with additional therapies such as topical medicines or phototherapy.ConclusionOverall, the evidence reported in this study demonstrates that microneedling is an essential advancement in melasma treatment. Not only can it improve the efficacy of topical drugs and other treatment modalities, but it also has an excellent safety and tolerability profile, making it desirable to patients and clinicians. While the current findings are encouraging, more study is needed to refine treatment protocols, investigate the long‐term consequences of microneedling, and establish it as the standard of care for melasma treatment. We anticipate that microneedling will play an increasingly important role in the future of melasma treatment, providing our patients with more hope and a broader choice of treatment alternatives.
Complex application of СО2 laser and tranexamic acid in the treatment of melasma in postmenopausal women (literature review)
Melasma is a common acquired pigmentation disorder, represented by patches of light brown or brown color localized on areas of the skin exposed to prolonged sunlight. The increased activity of melanocytes, which underlies the pathogenesis of melasma, is due to genetic predisposition, chronic insolation and hormonal imbalance. In postmenopausal women, the increased severity of melasma is associated with a combination of these factors. In addition, pigmentation disorders may be affected by taking certain medications and other environmental factors. There are many methods of treating melasma, including the use of topical remedies, chemical peels, laser therapy and others. In recent years, more and more attention has been paid to an integrated approach that combines various treatment methods to achieve the best result. One of the effective methods of treating this pathology is the use of a CO2 laser. However, many patients relapse after laser treatment. In this regard, there has been interest in the combined use of laser therapy using topical agents that reduce the severity of pigmentation. One of these drugs is tranexamic acid, which has the property of reducing the activity of melanocytes.The purpose of this literature review is to study the latest publications on the treatment of melasma using laser-associated administration of tranexamic acid.Material and methods. The literature data on search words – melasma, hyperpigmentation, tranexamic acid, CO2 laser, fractional grinding, laser-associated administration, postmenopause in computer databases PubMed, Elibrary, Cochrane Library, Medscape were studied. Web of Science, Scopus. Publications included basic scientific research, randomized controlled trials, comments and reviews. The results of clinical improvement were assessed by the MASI melasma area and severity index, as well as the modified mMASI index.
Clinical Efficacy of Cysteamine Application for Melasma: A Meta-Analysis
Background: Melasma is a challenging, acquired hyperpigmentary disorder. The gold standard treatment is Kligman’s formulation, which contains hydroquinone, tretinoin, and dexamethasone, but its long-term use is limited by the risk of exogenous ochronosis. Cysteamine, a tyrosinase inhibitor, reduces melanocyte activity and melanin production, showing strong depigmenting effects in patients resistant to Kligman’s formulation. Nonetheless, clinical studies have yielded inconsistent efficacy results. This meta-analysis aimed to assess the efficacy of cysteamine in treating melasma and to identify potential factors that may impact its therapeutic outcomes. Methods: A systematic search of PubMed, Embase, Web of Science, and CENTRAL, from the earliest record until August 2024, was conducted. Randomized controlled trials and quasi-randomized design studies related to topical cysteamine on melasma patients were included. The primary outcome was MASI or mMASI assessment after treatments. The current meta-analysis was conducted with a random-effects model. Subgroup analyses and meta-regressions were performed based on baseline MASI, disease duration of melasma, patient age, and sample size of the included studies. Funnel plots and Duval and Tweedie’s trim and fill method were adopted to assess the publication bias. Results: Eight studies were included for quantitative analysis. The analysis of MASI after topical cysteamine demonstrated a significant decrease compared to the placebo (p = 0.002). Compared to other melasma treatments, cysteamine did not show superior efficacy in mMASI (p = 0.277). The treatment efficacy of hydroquinone, modified Kligman’s formula, and tranexamic acid mesotherapy for melasma was not statistically different when compared to cysteamine (p = 0.434). Further analyses showed no benefit when allowing extended cysteamine application time (p < 0.0001). The meta-regression revealed the efficacy of cysteamine decreased as the duration of melasma increased (coefficient = 0.38, p = 0.0001, R2 = 0.99). The funnel plot displayed some asymmetry. The trim and fill method suggested the adjusted effect size was 0.607 (95% CI = −0.720 to 1.935). Conclusions: Cysteamine exhibited efficacy in treating melasma patients; however, its depigmentation effect was comparable to hydroquinone-based regimens, tranexamic acid mesotherapy, and modified Kligman’s formula. Using cysteamine in patients with a short duration of melasma may result in better efficacy.
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