射频导入参棘软膏联合口服氨甲环酸、谷胱甘肽治疗黄褐斑疗效观察

目的: 观察射频导入参棘软膏联合口服氨甲环酸、谷胱甘肽治疗黄褐斑的疗效。方法: 门诊女性黄
褐斑64 例,根据随机原则,分为治疗组和对照组,均为32 例。对照组病人口服氨甲环酸250 mg /次,2 次/d; 谷胱
甘肽400 mg /次,3 次/d,服用16wk。治疗组在对照组基础上采用舒敏专家射频导入参棘软膏,1 次/wk,共治疗
16 次。取两组病人治疗时间点第4、8、12、16wk 进行疗效标准判定及治疗前、后黄褐斑皮损面积和严重度指数
( MASI) 评分。同时记录起效时间、复发情况及不良反应,治疗疗程结束后以问卷方式调查病人满意度。结果:
治疗组和对照组治疗各观察时间点第4、8、12、16wk 总有效率分别为15．63%、46．88%、59．38%、84．38%和12．50%、
21．88%、44．00%、62．50%。治疗组治疗疗效与对照组比较差异有显著性( P＜ 0．05) ; 治疗组治疗16wk 后平均
MASI 评分明显下降至6．15±3．25分,与对照组比较,其差异具有显著性( P＜0．05) 。结论: 射频导入参棘软膏联合
口服氨甲环酸、谷胱甘肽治疗黄褐斑的临床疗效良好,方法简单,病人耐受性好,适合临床应用。     

Efficacy of topical vitamin C in melasma and photoaging: A systematic review

Background

Vitamin C is a micronutrient present in high concentrations in normal skin and a highly prescribed cosmeceutical, well known for protecting against ultraviolet-induced pigmentation and regulating collagen production. However, there is a lack of studies evaluating the efficacy of topical vitamin C in photoaging and melasma, with this systematic review being the first to assess the existing evidence.

Aim

This systematic review aims to assess whether topical vitamin C could be effective in reversing photoaging signs and treating melasma.

Methods

Prospective, randomized controlled trials assessing protocols with topically applied vitamin C in patients with melasma or photodamage were searched in Medline, CENTRAL, and Scopus databases until the 12th of May 2022. Risk of bias was conducted in accordance with Cochrane Collaboration's tool for assessing the risk of bias in randomized trials, using RevMan 5.0.

Results

Seven publications were included, with 139 volunteers in total. Studies that evaluated the topography of skin indicated that the treated skin appeared smoother and less wrinkled, which was supported by biopsies data. On objective assessments of pigmentation, there was a significant lightening of the skin treated. Hydration improved equally in the vitamin C and placebo-treated sites.

Conclusions

This study revealed that vitamin C is effective in treating uneven, wrinkled skin and has depigmenting properties, but long-term use may be needed to achieve noticeable changes. Q-switched Nd:YAG laser-associated protocols appear beneficial in enhancing vitamin C effects. Topical vitamin C may be a suitable alternative for melasma and photoaging, but more studies are needed to confirm these results and assess the ideal vitamin C concentration.     

Effectiveness of combination therapy of broadband light and intradermal injection of tranexamic acid in the treatment of chloasma

Objective

To investigate the efficacy and safety of broadband light (BBL) combined with intradermal injection of tranexamic acid for treating melasma.

Methods

120 women with melasma admitted to our hospital from January 2021 to April 2022 were randomly categorized into the following groups: control group, treated with 250 mg tranexamic acid given orally twice daily, except during menstruation; group I, treated with BBL (Sciton, Inc., USA) monthly; group II, received intradermal injections of tranexamic acid monthly; and group III, treated with BBL with intradermal injection of tranexamic acid monthly. Treatment in each group lasted three months. The MASI (Melasma Area Severity Index) and VISIA (Canfield VISIA Complexion Analysis) were used for evaluation.

Results

After treatment course, MASI scores and VISIA brown spot and red zone ranking improved in all four groups (p < 0.05). The decrease in MASI scores and improvement rates of VISIA brown spot and red zone rankings were not significantly different among the control group, group I, and group II; however, the decreased MASI scores and improvement rates of VISIA brown spot and red zone rankings were significantly higher in group III than in the other three groups (p < 0.05).

Conclusion

The effect of BBL combined with the intradermal injection of TA in the treatment of melasma is remarkable. This combination therapy can be an alternative and effective treatment for managing melasma.     

光电技术在黄褐斑治疗中的应用

 黄褐斑是一种好发于女性面部的色素增加性皮肤病,治疗是目前的难点,成功率较低,而复发率较高。近年来,光电技术治疗黄褐斑在国内外取得了满意疗效,主要包括强脉冲光、Q开关激光、点阵激光、皮秒激光、脉冲染料激光、射频技术等。其中强脉冲光、Q开关激光、皮秒激光治疗黄褐斑的疗效及安全性得到了广泛认可,其他光电技术的疗效及安全性还有待于进一步研究。本文就光电技术在黄褐斑治疗中的应用作一综述。     

Significant therapeutic response to cysteamine cream in a melasma patient resistant to Kligman's formula

L‐Cysteamine is a biological antioxidant produced during the coenzyme A metabolism cycle and is naturally present in all mammalian cells. The efficacy of topical cysteamine for the treatment of melasma has been recently shown in two double‐blind, randomized, and placebo‐controlled clinical trials. Herein, we report a 44‐year‐old patient with melasma resistant to Kligman's formula (Pigmanorm cream), who was successfully treated with topical cysteamine as a new depigmenting agent. Skin colorimetric measurements, MASI score determination, and standard photographies after 2 and 4 months of once daily application of cysteamine cream showed a marked improvement of the hyperpigmented lesions. Telangiectasia and perilesional hypopigmentation improved rapidly after the discontinuation of Kligman's formula and starting the treatment with topical cysteamine. After 4 months, the therapeutic results were maintained through a biweekly application regimen of cysteamine cream. The use of cysteamine cream was well tolerated and did not induce any side effects during the 3‐year follow‐up of the patient. Cysteamine is a natural molecule with an excellent safety profile and known antimutagenic, antimelanoma, and anticarcinogenic effects. Considering the high efficacy of cysteamine cream, it is possible that it could replace mutagenic and carcinogenic depigmenting agents such as hydroquinone in near future.     

New insight in the treatment of refractory melasma: Laser Q‐switched Nd: YAG non‐ablative fractionated followed by intense pulsed light

The purpose of our study was to verify the results of the association of Q‐switched Nd: YAG non‐ablative fractionated with intense pulsed light, in order to treat patients with refractory melasma. The combination of these two devices seems to be the best treatment to combat hyperpigmentation produced by melasma, with low occurrence of side effects, which may be justified by the selective photothermolysis at subcellular level.