Comparing the Efficacy of Patelet-rich Plasma (PRP) versus Tranexamic Acid (4mg/mL) as Intradermal Treatments of Melasma

Melasma is a chronic skin condition that involves the overproduction of melanin in areas exposed to ultraviolet radiation. Melasma treatment is long-term and complicated with recurrence and resistance to treatment. The pathogenesis of melasma is highly complex with multiple pathologies occurring outside of the skin pigment cells. It includes photoaging, excessive melanogenesis, an increased number of mast cells, increased vascularization, and basement membrane damage. In addition, skin lesions related to melasma and their surrounding skin have nearly 300 genes differentially expressed from healthy skin. Traditionally, melasma was treated with topical agents, including hydroquinone, tretinoin, glucocorticosteroids and various formulations; however, the current approach includes the topical application of a variety of substances, chemical peels, laser and light treatments, mesotherapy, microneedling and/or the use of systemic therapy. The treatment plan for patients with melasma begins with the elimination of risk factors, strict protection against ultraviolet radiation, and the topical use of lightening agents. Hyperpigmentation treatment alone can be ineffective unless combined with regenerative methods and photoprotection. In this review, we show that in-depth knowledge associated with proper communication and the establishment of a relationship with the patient help to achieve good adherence and compliance in this long-term, time-consuming and difficult procedure.

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“…The work of Mumtaz et al [236] is also of interest. They compared the effectiveness of mesotherapy with TA and platelet-rich plasma (PRP).…”

Section: Mesotherapymentioning

confidence: 98%

Understanding Melasma-How Can Pharmacology and Cosmetology Procedures and Prevention Help to Achieve Optimal Treatment Results? A Narrative Review

Piętowska

Nowicka

Szepietowski

2022

IJERPH

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“…Four of the eight included studies comparing the MASI between experimental (PRP treatment) group and control group were reviewed [ 1 , 3 , 18 , 20 ]. The baseline MASI were comparable between experimental and control groups in all included studies ( p > 0.05).…”

Section: Masimentioning

confidence: 99%

“…Chloasma is a pigmentation disorder that mostly affects women's faces. The cheeks, forehead, chin, lips, and neck are the most common areas exposed to the sun, but other areas are not uncommon [ 1 ]. The main clinical manifestation of brown facial patches has a significant impact on the patient's appearance and quality of life [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, some recent studies show that the key pathology needs to control melanin production by adjusting the activities of extracellular kinase and prostaglandin E2 (PGE2). In addition, it guides extracellular matrix remodeling, strengthens the expression of matrix metalloproteinases, eliminates extracellular matrix elements damaged by light, and stimulates fibroblast proliferation and collagen synthesis [ 1 ]. In summary, PRP can reduce pigmentation and brighten skin tone [ 10 ], which is also the primary need of patients with chloasma.…”

Section: Introductionmentioning

confidence: 99%

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Application of PRP in Chloasma: A Meta-Analysis and Systematic Review

Deng

Cheng

Guo

et al. 2022

Computational Intelligence and Neuroscience

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Background. Chloasma is a common skin pigment disorder. Treatment of chloasma has been challenging, often unsatisfactory, and difficult to avoid recurrence. PRP is a new treatment for chloasma, but there is no consensus on its use. Lingyun Zhao’s team recently reported a systematic evaluation and meta-analysis of the efficacy and safety of PRP in the treatment of chloasma, which is consistent with our ideas, but we will elaborate on the application of PRP in chloasma from a deeper and more comprehensive perspective. Before we started this study, we had registered with Prospero as CRD42021233721. Methods. The authors searched the public medical network, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ScienceDirect, Scopus, and Science Network. The clinical trials registry ClinicalTrials.gov databases were searched for relevant publications to June 2021. The results showed the area and severity of chloasma (MASI) or revised MASI (mMASI) score. Results. Three RCTs, one nonrandomized controlled study, and four were prospective before and after self-controlled studies met the inclusive criteria. Intradermal PRP injections significantly improved chloasma as indicated by the significant decrease MASI (average balance -6.71, 95% CI -8.99 to -4.33) and mMASI scores (average balance -2.94, 95% CI -4.81 to -1.07). The adverse reactions were mild, and there were no significant long-term adverse events. Conclusive. The data can reflect the effectiveness and safety of PRP therapy for chloasma. RCTs are needed to determine effective treatment parameters, and long-term follow-up should be included to better clarify the efficacy and side effects of PRP in treating chloasma.

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“…PRP is considered a promising treatment for acne and hyperpigmentation. 7 However, few systematic studies have been conducted on the value of combined application of TXA and PRP against melasma. In this study, we explored the outcomes of a treatment for melasma combining TXA and PRP.…”

Section: Introductionmentioning

confidence: 99%

Effect of platelet-rich plasma combined with tranexamic acid in the treatment of melasma and its effect on the serum levels of vascular endothelial growth factor, endothelin-1 and melatonin

Zhang

Wu²,

Shen³

2022

Pak J Med Sci

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Objective: To investigate the effect of platelet-rich plasma (PRP) combined with tranexamic acid (TXA) in the treatment of melasma and its effect on the serum levels of vascular endothelial growth factor (VEGF), endothelin-1 (ET-1) and melanin stimulating hormone (MSH). Methods: We retrospectively analyzed clinical data of 80 patients with melasma treated in our hospital from January 2020 to June 2021. Patients (n=38) in the control group received simple oral TXA treatment. Patients (n=42) in the study group received PRP combined with oral TXA treatment. We assessed the treatment effects on the serum biochemical index levels, the adverse reactions, and the recurrence rates in the two groups. Results: The total efficacy of the study group (90.48%) was higher than that of the control group (73.68%) (p<0.05). After the treatment, the levels of serum VEGF increased and the levels of ET-1 and MSH decreased in both groups, but the changes in the study group were more pronounced than those in the control group (p<0.05). We found similar incidences of the adverse reaction in the study group (7.14%) and the control group (5.26%; p>0.05). The disease recurrence rates between the two groups three months after the treatment were similar (p>0.05). However, the disease recurrence rate in the study group (4.76%) was lower than that in the control group (21.05%) 6 months after treatment (p<0.05). Conclusions: PRP combined with oral TXA can improve the treatment effect of TXA alone in the treatment of melasma, maintaining normal levels of VEGF, ET-1 and MSH, reducing disease recurrences. doi: https://doi.org/10.12669/pjms.38.8.6786 How to cite this:Zhang C, Wu T, Shen N. Effect of platelet-rich plasma combined with tranexamic acid in the treatment of melasma and its effect on the serum levels of vascular endothelial growth factor, endothelin-1 and melatonin. Pak J Med Sci. 2022;38(8):2163-2168. doi: https://doi.org/10.12669/pjms.38.8.6786 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Comparing the Efficacy of Patelet-rich Plasma (PRP) versus Tranexamic Acid (4mg/mL) as Intradermal Treatments of Melasma

Abstract: Objective: To compare the efficacy of intradermal platelet-rich-plasma vs. intradermal tranexamic acid in treatment of melasma. Study Design: Non-randomised controlled trial.

Cited by 12 publications

References 3 publications

Understanding Melasma-How Can Pharmacology and Cosmetology Procedures and Prevention Help to Achieve Optimal Treatment Results? A Narrative Review

Understanding Melasma-How Can Pharmacology and Cosmetology Procedures and Prevention Help to Achieve Optimal Treatment Results? A Narrative Review

Application of PRP in Chloasma: A Meta-Analysis and Systematic Review

Effect of platelet-rich plasma combined with tranexamic acid in the treatment of melasma and its effect on the serum levels of vascular endothelial growth factor, endothelin-1 and melatonin

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