Melasma

Doolan, Brent J; Gupta, Monisha

doi:10.31128/ajgp-05-21-6002

Cited by 21 publications

(15 citation statements)

References 17 publications

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“…The etiopathogenesis remains unclear; however, factors implicated include family history, ultraviolet radiation (UV) exposure, medications, and hormonal imbalances 1 . Melasma can be divided into epidermal, dermal, and mixed types based on the depth of melanogenesis 2 . The Melasma Area and Severity Index (MASI) and modified Melasma Area and Severity Index (mMASI) are validated and reliable tools to evaluate melasma severity and are used as a standard outcome measurement of melasma treatment efficacy 3 .…”

Section: Introductionmentioning

confidence: 99%

“…1 Melasma can be divided into epidermal, dermal, and mixed types based on the depth of melanogenesis. 2 The Melasma Area and Severity Index (MASI) and modified Melasma Area and Severity Index (mMASI) are validated and reliable tools to evaluate melasma severity and are used as a standard outcome measurement of melasma treatment efficacy. 3 This tool considers the surface area, darkness, and homogeneity of melasma in four different areas of the face.…”

Section: Introductionmentioning

confidence: 99%

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Tranexamic acid in melasma: A focused review on drug administration routes

Konisky

Balazic

Jaller

et al. 2023

J of Cosmetic Dermatology

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Background: Melasma is a disorder of hyperpigmentation and vascularization often found in women between the ages of 20 and 40. The pathogenesis is unknown, but melasma often occurs in sun-exposed areas of the face, forearms, and back. Risk factors include family history, increased estrogen/progesterone, certain medications, and UV exposure. Melasma is typically treated with topical hydroquinone (HQ); however, it is often refractory to treatment. Tranexamic acid (TXA) is a plasmin inhibitor used off-label in the treatment of melasma. TXA can be administered orally, topically, or intralesionally. Aims:The purpose of this review is to characterize the wide variety of TXA delivery methods for melasma treatment and the efficacy of these methods compared with traditional treatments.Patients/Methods: A comprehensive PubMed and Embase search was conducted in May 2022 using the phrases tranexamic acid and melasma. Forty-six articles were included in this review.Results: Oral, intralesional, and topical TXA is safe and effective treatments for melasma. They have been studied in a variety of randomized controlled trials and have been compared with several traditional treatments. Overall, MASI scores in patients using TXA in any form improved. Conclusions:Oral TXA was found to be the most effective, especially in cases of refractory melasma; however, it caused GI upset and menstrual irregularities in many patients. The pro-thrombotic nature of this drug must be considered before safely prescribing to patients. Intralesional injections and microneedling with topical TXA were found to be effective alternatives to oral treatment. Lastly, topical TXA alone was found to be the least effective method but can be combined with other cosmeceuticals to improve outcomes. Topical TXA was also found to be better tolerated than hydroquinone, a traditional topical melasma treatment.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tranexamic acid in melasma: A focused review on drug administration routes

Konisky

Balazic

Jaller

et al. 2023

J of Cosmetic Dermatology

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“…Participants were assessed as eligible if they satisfied the following: Female aged between 20 and 60 years, met the Clinical Diagnosis and Effectiveness Criteria for melasma [7], signed the informed consent form voluntarily, received treatment in the hospital throughout the process, and did not drop out from the study mid-way.…”

Section: Inclusion Criteriamentioning

confidence: 99%

Effectiveness of the external application of Jidesheng snake tablets, trehalose glycerin mud, and hydroquinone cream in the treatment of melisma

Chen¹,

Chen²,

Zhao³

et al. 2023

Trop. J. Pharm Res

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Purpose: To determine the effectiveness of the external application of Jidesheng snake tablets, trehalose glycerin mud, and hydroquinone cream in the treatment of melasma. Methods: The study was conducted on 60 patients with melasma who were treated in the Affiliated Yueqing Hospital of Wenzhou Medical University between January 1, 2021, and January 31, 2022. The patients were randomly but equally assigned to two groups (study and control). The study group received Jidesheng snake medicine, glycerin, boiled water, and trehalose medicinal mud at a 10:4:2:1 combination ratio, applied to the affected parts 12 h a day for 2 - 4 weeks. After cleansing the skin, hydroquinone cream was applied to the affected area. On the other hand, the control group was treated with a similar formulation but without trehalose medicinal mud in the ratio of 10:4:2. Changes in facial melasma of the patients were observed, while the satisfaction, clinical efficacy, incidence of adverse reactions, and recurrence rate were monitored. Results: Patients in the study group were more satisfied with the treatment than those in the control group (90 vs. 73.3 %, p < 0.05). Furthermore, treatment effectiveness was significantly higher in the study group than in the control group (93.3 vs. 70 %, p < 0.05). Conclusion: The external application of Jidesheng medicine + glycerin + cold boiled water + trehalose is a reliable therapeutic strategy for the management of patients with melasma. It is more cost-effective, less prone to adverse reactions, and is associated with a low recurrence rate and high satisfaction.

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“…13,75 PBM may contribute to these actions by inhibiting the activity of TYR and other enzymes involved in melanin synthesis; downregulate MITF, TYR, TRP-1, and TRP-2 at the gene and protein levels; and inhibit melanogenesis by promoting autophagy. Finally, chemical peels 76,77 and dermabrasion 75,78,79 are the main choices to remove melanin from the epidermis.…”

Section: Impli C Ati On S For Clini C Al Pr Ac Ti Cementioning

confidence: 99%

Photobiomodulation for melasma treatment: Integrative review and state of the art

Galache,

Sena,

Tassinary

et al. 2023

Photoderm Photoimm Photomed

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PurposePhotobiomodulation therapy (PBM) is a versatile technique for treating skin diseases. Melasma, a chronic hyperpigmentation condition, has recently been associated with vascular features and dermal photoaging and poses significant management challenges. We review the recent literature on melasma etiology and the evidence supporting PBM as a therapeutic modality for melasma treatment.MethodsWe conducted a comprehensive literature search in three different databases from May to August 2023, focusing on studies published in the past 10 years. The inclusion criteria comprised full‐text studies investigating low‐power lasers and/or light‐emitting diodes (LEDs) in in vitro or in vivo models, as well as clinical trials. We excluded studies discussing alternative melasma therapies or lacking experimental data. We identified additional studies by searching the reference lists of the selected articles.ResultsWe identified nine relevant studies. Clinical studies, in agreement with in vitro experiments and animal models, suggest that PBM effectively reduces melasma‐associated hyperpigmentation. Specific wavelengths (red: 630 nm; amber: 585 and 590 nm; infrared: 830 and 850 nm) at radiant exposures between 1 and 20 J/cm2 exert modulatory effects on tyrosinase activity, gene expression, and protein synthesis of melanocytic pathway components, and thus significantly reduce the melanin content. Additionally, PBM is effective in improving the dermal structure and reducing erythema and neovascularization, features recently identified as pathological components of melasma.ConclusionPBM emerges as a promising, contemporary, and non‐invasive procedure for treating melasma. Beyond its role in inhibiting melanogenesis, PBM shows potential in reducing erythema and vascularization and improving dermal conditions. However, robust and well‐designed clinical trials are needed to determine optimal light parameters and to evaluate the effects of PBM on melasma thoroughly.

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Melasma

Cited by 21 publications

References 17 publications

Tranexamic acid in melasma: A focused review on drug administration routes

Tranexamic acid in melasma: A focused review on drug administration routes

Effectiveness of the external application of Jidesheng snake tablets, trehalose glycerin mud, and hydroquinone cream in the treatment of melisma

Photobiomodulation for melasma treatment: Integrative review and state of the art

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