Split-face comparative study between intradermal tranexamic acid injection alone versus intradermal tranexamic acid injection combined with Q-switched Nd:YAG laser in melasma treatment: dermoscopic and clinical evaluation

Hawwam, Soha Abdalla; Ismail, Mayada; El-Attar, Yasmina Ahmed

doi:10.1007/s10103-021-03483-y

Cited by 6 publications

(5 citation statements)

References 18 publications

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“…These results align with the meta-analysis of five RCTs, which showed that laser modalities combined with TXA significantly decreased the MASI/mMASI scores, while no serious adverse events were observed, except mild erythema and burning pain [43]. The efficacy of LADD will probably render the intradermal tranexamic acid injections alone or combined with Q-switched Nd-YAG laser, though effective, obsolete due to the associated pain from injection despite topical anesthetic cream used [44].…”

Section: Discussionsupporting

confidence: 79%

Laser-Assisted Drug Delivery on the Face: A Systematic Review of Indications and Outcomes

Seretis,

Papaioannou

2023

Cosmetics

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Laser-assisted drug delivery (LADD) has gained prominence as a promising technique with the potential to enhance topical drug skin penetration and absorption. However, the effectiveness of various laser-assisted facial procedures remains unclear. This systematic review aimed to explore and summarize the evidence regarding the indications, clinical outcomes, and adverse effects of LADD performed on the face. Based on a predetermined protocol, an electronic search in MEDLINE, Scopus, the Cochrane Library, and CENTRAL electronic databases was conducted. Eligible studies comprised prospective controlled trials that explored the utility of laser-assisted techniques for topical medication facial application and reported on efficacy and/or safety. Secondary outcomes encompassed patient satisfaction. This review included 12 prospective controlled studies involving a total of 271 participants. LADD, through various laser types, topical medications, clinical protocols, and follow-up assessments, showed enhanced melasma, facial rejuvenation, scar, and periprocedural laser outcomes without increased risk of adverse effects. This review provides evidence that LADD is an effective and safe adjunct for various facial procedures. It also highlights the necessity for further high-quality studies with larger sample sizes, standardized treatment protocols, and evaluation of long-term outcomes and adverse effects in order to elucidate the potential of laser-assisted drug delivery.

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Section: Discussionsupporting

confidence: 79%

Laser-Assisted Drug Delivery on the Face: A Systematic Review of Indications and Outcomes

Seretis,

Papaioannou

2023

Cosmetics

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“…A total of 44 RCTs were included, 16–18,25–65 with a cumulative sample size of 3164 cases. Interventions related to TA include oTA, oTA + laser, oTA + RTA, tTA, tTA + laser, iTA, iTA + laser, MNsTA and placebo.…”

Section: Resultsmentioning

confidence: 99%

“…To investigate the reason, the dose and frequency of oTA or with RTA agents were 500 mg/day, 16,17,31,36,37,54,55,57,63,64 while the frequency of iTA and MNsTA was basically once every 2 or 4 weeks, and the concentration of liquid medicine was 4 mg/mL. [16][17][18]27,33,36,39,40,47,48,51 Therefore, oTA with high-frequency and concentration had a faster effect than iTA and MNsTA. In these studies, oTA or with RTA agents produced an early response and cleared melasma at Week 4, and tTA, iTA and MNsTA responded slowly in the first 4 weeks with only mild improvement or no response, while the improvement continued, with a moderate to good response in most patients at Week 8.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the onset time of various TA administration methods, our research results show that the onset time of oTA or with RTA is about 4 weeks, and the onset time of tTA, iTA and MNsTA is about 8 weeks. To investigate the reason, the dose and frequency of oTA or with RTA agents were 500 mg/day, 16,17,31,36,37,54,55,57,63,64 while the frequency of iTA and MNsTA was basically once every 2 or 4 weeks, and the concentration of liquid medicine was 4 mg/mL 16–18,27,33,36,39,40,47,48,51 . Therefore, oTA with high‐frequency and concentration had a faster effect than iTA and MNsTA.…”

Section: Discussionmentioning

confidence: 99%

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Comparative efficacy and safety of tranexamic acid for melasma by different administration methods: A systematic review and network meta‐analysis

Liang,

Luo,

Pan

et al. 2023

J of Cosmetic Dermatology

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BackgroundTranexamic acid (TA) is a new and promising drug for the treatment of melasma.ObjectivesThis network meta‐analysis aims to compare the efficacy and safety of various ways of administration of TA on melasma.MethodsWe collected researches from PubMed, EMBASE, Cochrane Library and Web of Science. Melasma area severity index (MASI) is used to evaluate the severity of melasma. After treatment with different TA administration methods, a difference in MASI is named ΔMASI. We evaluate the curative effect by comparing the ΔMASI of different TA administration methods at a certain time point.ResultsAt the Weeks 4, 8, and 12 and the last follow‐up, the ΔMASI of oral TA combined with routine topical agents (oTA + RTA) was higher than that of intradermal TA (iTA), topical TA (tTA) as well as microneedling TA (MNsTA), with statistical significance. At the 8th week, the ΔMASI of oTA was higher than that of iTA, with statistical significance. Compared with placebo, oTA showed statistically significant differences at Week 4, while tTA, iTA, and MNsTA showed statistically significant differences starting from Week 8.ConclusionsAmong various ways of administration of TA, oTA + RTA has the best effect on melasma. In the short term, the curative effect of oTA is better than that of iTA, and the onset time of oTA is faster than that of tTA, iTA and MNsTA. In the long run, the curative effect of TA alone has nothing to do with the mode of administration.

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“…Since there is no cell death and skin heating is kept to a minimum, the risk of melasma exacerbation is much lower. This technique achieved the best results and the lowest risk of recurrence when it is combined with other agents such as topical HQ [199,200], triple combination cream [201], azelaic acid [202], chemical peels, e.g., Jessner's formula [203,204], GA [205,206] and systemic treatment with TA [199,[207][208][209][210], as well as other treatment procedures, such as microneedling with ascorbic acid [211], microneedle radiofrequency (RF) [212], microdermabrasion [213], pulsed-dye laser [214], and IPL [188,215,216]. In each of these cases, combination therapy was more effective than the laser toning procedure alone [197,217].…”

Section: Laser Therapymentioning

confidence: 99%

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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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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Split-face comparative study between intradermal tranexamic acid injection alone versus intradermal tranexamic acid injection combined with Q-switched Nd:YAG laser in melasma treatment: dermoscopic and clinical evaluation

Cited by 6 publications

References 18 publications

Laser-Assisted Drug Delivery on the Face: A Systematic Review of Indications and Outcomes

Laser-Assisted Drug Delivery on the Face: A Systematic Review of Indications and Outcomes

Comparative efficacy and safety of tranexamic acid for melasma by different administration methods: A systematic review and network meta‐analysis

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

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