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, Ci; Wu, Teng; Shen, Nan

doi:10.12669/pjms.38.8.6786

Cited by 10 publications

(13 citation statements)

References 22 publications

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“…In a study by Zhang et al, who investigated 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), they reported that PRP combined with TXA can improve the treatment outcome, maintaining normal levels of VEGF, ET-1 and MSH, and reducing the recurrence rate [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Intradermal injection of tranexamic acid versus platelet-rich plasma in the treatment of melasma: a split-face comparative study

Elraouf¹,

Obaid

Fouda

2023

Arch Dermatol Res

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Millions of people throughout the world suffer from the acquired condition of hyperpigmentation known as melasma. Melasma is characterized by symmetrically oriented hyperpigmented macules and patches. Many treatment options are available with variable degrees of efficacy and tolerability. The aim of the work was to evaluate and compare the effectiveness and safety of intradermal tranexamic acid (TXA) versus intradermal platelet-rich plasma (PRP) in the treatment of various types of melasma. The current split-face prospective study included 40 cases with melasma. Tranexamic acid (TXA) was injected intradermally into the right side of the face by using a concentration of 4 mg/ml, while platelet-rich plasma (PRP) was injected intradermally into the left side. In both sides, a total of three sessions of treatment were provided, once every 4 weeks. Digital photographs were taken before each treatment session and 3 months after the last session. The modified melasma area severity index (mMASI) grading system and dermoscopy were used to assess the improvement in the condition. The disease severity and percentage of improvement were assessed by mMASI score before and after therapy across both sides of the face. along with determining the degree of satisfaction and side effects among the included cases. The mean mMASI score before therapy in the TXA side was 4.59 ± 2.87, while in the PRP side, the mean mMASI score before therapy was 4.72 ± 2.72 with no statistically significant difference between the two sides (p = 0.841). After 3 months of treatment, the mean mMASI score in the TXA-treated side was 2.49 ± 1.58 with a mean percentage of decrease of 45.67 ± 8.10%, while in the PRP side, the mean mMASI score after treatment was 2.17 ± 1.41 with a mean percentage of decrease of 53.66 ± 11.27%. There was a high statistically significant decrease in the mMASI score after treatment on both sides (p < 0.001); however, the percentage of score reduction in the PRP side compared to the TXA side was statistically higher. Intradermal injection with PRP revealed higher efficacy in the treatment of melasma as compared to TXA injection with no significant difference regarding the associated side effects.

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Section: Discussionmentioning

confidence: 99%

Intradermal injection of tranexamic acid versus platelet-rich plasma in the treatment of melasma: a split-face comparative study

Elraouf¹,

Obaid

Fouda

2023

Arch Dermatol Res

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“…24 In a study by Zhang et al, who investigated the effect of platelet-rich plasma combined with tranexamic acid (Tranexamic acid) 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), they reported that PRP combined with Tranexamic acid can improve the treatment outcome, maintaining normal levels of VEGF, ET-1 and MSH, and reducing the recurrence rate. 25 Due of its autologous nature, PRP therapy has a higher safety profile. A further benefit is the abundance of growth factors which facilitate a number of mechanisms that result in facial rejuvenation.…”

Section: Discussionmentioning

confidence: 99%

A comparison of the effectiveness of intralesional tranexamic acid against platelet-rich plasma in the treatment of melasma

Karthikeyan,

Kumar,

Radhakrishnan

2024

Int J Res Dermatol

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Background: Melasma, derived from the Greek word "melas" meaning "black", manifests as an acquired, more or less symmetrical hypermelanosis of sun-exposed skin. This study aimed to compare and evaluate the efficacy and safety of intradermal injection of tranexamic acid and platelet-rich plasma in treating various types of melasma. Methods: Conducted from June 2022 to December 2023 at the outpatient department of dermatology, Sri Lakshmi Narayana institute of medical sciences, Puducherry, this split-face prospective study involved 40 melasma cases. Tranexamic acid (4 mg/ml) was intradermally injected into the right side of the face, while PRP was injected into the left side. Improvement was assessed using the modified Melasma area severity index (MASI) grading system and dermoscopy, measuring disease severity and percentage of improvement before and after therapy on both sides of the face. Results: The study comprised predominantly females (80%) aged 20 to 30 years (50%), followed by those aged 30 to 40 years (35%). Most cases (93%) exhibited a gradual onset, with centrofacial (52.5%) and malar (37.5%) patterns being predominant. Mixed pattern (67.5%) was common. Pre-treatment mean MASI scores for tranexamic acid and PRP sides were 7.54 and 6.92, respectively, with post-treatment scores of 4.6 and 2.83, respectively. Conclusions: Intradermal PRP demonstrated significantly superior efficacy over intradermal tranexamic acid in managing melasma, particularly in the longer term. Thus, PRP, coupled with good compliance, may substantially reduce the disease burden compared to conventional tranexamic acid treatment.

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“…7 Therefore, anti-VEGF drugs have emerged as potential agents to improve the therapeutic effect of DME. 7,8 Ranibizumab is a second-generation humanized recombinant monoclonal antibody fragment against VEGF, which can selectively bind to VEGF and inhibit endothelial cell proliferation, thereby exerting therapeutic effects. 9,10 Several studies have suggested the superiority of combining laser treatment with anti-VEGF therapy in patients with DME.…”

Section: Introductionmentioning

confidence: 99%

Effect of ranibizumab combined with laser photocoagulation in the treatment of diabetic macular edema

Hu,

Liao,

Xia

et al. 2024

Pak J Med Sci

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Objective: To explore the clinical effect of ranibizumab combined with laser photocoagulation (LP) in treating diabetic macular edema (DME). Methods: We retrospectively reviewed the clinical data of 118 patients with DME admitted to The Affiliated Eye Hospital of Nanchang University from May 2021 to March 2023. Among them, 38 patients received LP alone (Laser-group), 39 patients received ranibizumab alone (Ranibizumab-group), and 41 patients received LP combined with ranibizumab (Combined-group). The improvement of macular edema (ME), visual acuity, and complications between the groups were compared. Results: The time of ME regression, exudation absorption and fundus hemorrhage absorption in the Combined-group was shorter than in the Laser-group and the Ranibizumab-group (P<0.05). After treatment, the CMT and RNV of the three groups decreased compared to pretreatment levels and were lower in the Combined-group compared to the Laser-group and the Ranibizumab-group (P<0.05). BCVA increased after the treatment in all groups, and was markedly higher in the Combined-group than in the Laser and the Ranibizumab-groups (P<0.05). NO were higher in the Combined-group compared to the Laser-group and the Ranibizumab-group. The post-treatment VEGF levels decreased in all groups, and were significantly lower in the Combined-group compared to the Laser-group and the Ranibizumab-group (P<0.05). The incidence of complications in the Combined-group was lower than in the Laser-group and the Ranibizumab-group (P<0.05). Conclusions: Compared to ranibizumab or LP alone, ranibizumab combined with LP is more effective in reducing ME in patients with DEM, and is associated with fewer complications. doi: https://doi.org/10.12669/pjms.40.6.9213 How to cite this: Hu J, Liao H, Xia H, Liao Y, Yuan D. Effect of ranibizumab combined with laser photocoagulation in the treatment of diabetic macular edema. Pak J Med Sci. 2024;40(6):1099-1104. doi: https://doi.org/10.12669/pjms.40.6.9213 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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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

Cited by 10 publications

References 22 publications

Intradermal injection of tranexamic acid versus platelet-rich plasma in the treatment of melasma: a split-face comparative study

Intradermal injection of tranexamic acid versus platelet-rich plasma in the treatment of melasma: a split-face comparative study

A comparison of the effectiveness of intralesional tranexamic acid against platelet-rich plasma in the treatment of melasma

Effect of ranibizumab combined with laser photocoagulation in the treatment of diabetic macular edema

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