黄褐斑的治疗现状

黄褐斑是多发于中青年女性面部的色素沉着性皮肤病,其治疗方法不一,如内治、外治法,或中医药、西药、中西结合治疗等.各种疗效、复发问题以及可能出现的不良反应,一直是皮肤科临床医师所面临的棘手问题.外用去色素或脱色制剂仍是治疗黄褐斑最常用的有效方法.     

黄褐斑的治疗

黄褐斑的治疗除避免易患因素、口服和外用避光药外,局部治疗以Kligman的改良配方(4％氢醌、0.05％维A酸和0.05％倍他米松)效果显著,但高浓度氢醌及(或)长时间使用可产生副作用。0.1％～0.4％甘草提取物LPT-40与0.05％维A酸和0.05％倍他米松联合治疗产生了满意效果。其它方法如化学剥脱似乎能产生协同作用。Silk Touch 二氧化碳激光机在难治的真皮型黄褐斑显示出良效。     

祛斑霜治疗黄褐斑

祛斑霜治疗黄褐斑王欣，高思银，魏俊华（山东德州地区人民医院皮肤科２５３０１４）我们自１９９０年４月～１９９１年８月开始使用自制中药祛斑霜治疗黄褐斑，取得较好疗效，现报告如下；一、临床资料：７６例患者，男２例，女７４例，年龄２３～５０岁，平均３０．４岁...     

中医治疗黄褐斑

黄褐斑 ,中医称“黧黑斑”。《医宗金鉴·外科心法要诀》认为本病 :“原于忧思抑郁 ,血弱不华 ,火燥结滞而生于面上 ,妇女多有之。”此病多见于女性 ,影响容颜使患者精神上有一定压力 ,给工作生活带来一定影响。临床上多将本病辨证分为肝郁气滞型、肝脾不和型、劳伤脾土型和肾气不足型治疗[1] 。本人在临床中遇到2例肾阳虚衰型患者 ,运用妇科名中医刘奉五老先生的“四二五合方”[2 ] 辩证加减治疗 ,取得满意疗效 ,现介绍如下。1　方剂组成加减“四二五合方”由当归 10ｇ,赤白芍各 10ｇ,川芎 6ｇ,生地 15ｇ ,女贞子 2 0ｇ,菟丝子 10ｇ ,车前…     

雪夫治疗黄褐斑疗效观察

我科于 1998年 10月～ 2 0 0 0年 5月用重庆华邦制药有限公司生产的雪夫(复方维Ａ酸制剂 ,包括 2种浓度的全反式维Ａ酸 ,即 0 .0 5 %和 0 .0 2 5 % )治疗5 4例黄褐斑患者 ,现将结果报告如下。1　资料与方法　1.1　临床资料　 5 4例均经皮肤科门诊确诊为黄褐斑患者 ,其中男 2例 ,女 5 2例 ;年龄 2 6岁～ 62岁 ,平均年龄 41.5岁 ;病程 4月～ 3 0年 ,平均 6年。所有患者 1月内均未接受其他祛斑药物的治疗 ,亦非妊娠及哺乳期妇女。1.2　方法　第 1～ 2周先用 0 .0 2 5 %的雪夫外涂于面部色斑处 ,1～ 2次 /ｄ ,然后视皮肤适应情况用 0 .0 5 %或 0…     

黄褐斑的病因及治疗

黄褐斑是一种获得性面部皮肤浅褐至深褐色色素沉着斑,现将其病因及治疗综述如下。病因１．黑素细胞刺激激素（ＭＳＨ）　Ｍａｒｉｅ等报道用αＭＳＨ孵育正常黑素细胞１２ｍｉｎ后,细胞内ｃＡＭＰ增加７倍,但４８ｈ后酪氨酸酶活性增加反而较轻（＜２０％）。血清βＭＳＨ的水平在黄褐斑患者与对照组相同,故有作者认为ＭＳＨ与黄褐斑关系不大。２．性激素　Ｃｌａｕｄｙ等报道一组经皮注射雌二醇同时用中波紫外浅（ＵＶＢ）进行亚红斑量光疗的妇女,在局部产生无炎症的色素沉着。用β雌二醇孵化正常黑素细胞２４ｈ后即可产生剂量依…     

黄褐斑的治疗现状

黄褐斑是多发于中青年女性面部的色素沉着性皮肤病,其治疗方法不一,如内治、外治法,或中医药、西药、中西结合治疗等。各种疗效、复发问题以及可能出现的不良反应,一直是皮肤科临床医师所面临的棘手问题。外用去色素或脱色制剂仍是治疗黄褐斑最常用的有效方法。     

黄褐斑研究治疗现况

主要发病原因是阳光与遗传素质。此外与体内的孕激素水平、黑色素细胞刺激激素(MSH)、肝脏疾病、甲亢、结核病、体内肿瘤、光感药物及药物过敏等有关。     

自配祛斑霜治疗面部黄褐斑53例

黄褐斑是高原地区青年妇女中常见并影响美容的皮肤病。它与高原地区长期强烈的紫外线照射和气候干燥有关。根据防晒、保湿，增白的原理，自配祛斑霜治疗面部黄褐斑取得满意疗效，现报告如下。临床资料门诊女性患者９８例，年龄１８～３４岁，平均２６岁。按就诊顺序随机分...     

Melasma: Treatment evaluation

Introduction: Melasma is a common disorder of facial hyperpigmentation that can be resistant to treatment. Our purpose is to evaluate the clinical efficacy of the different available modalities of treatment of melasma among Egyptian patients who have mostly skin types IV–V under a sunny climate. Methods: A total of 45 patients with moderate‐to‐severe melasma were subjected to topical application of hydroquinone 4% cream, chemical peeling with 30% trichloroacetic acid (TCA) and/or frequency‐doubled Q‐switched Nd:YAG laser therapy for an average of 6 months. Clinical evaluation and melasma severity were recorded using the melasma area and severity index (MASI) score. Results: The improvement score was significantly higher among the topically treated group compared with other lines of therapy (p<0.0001). No significant difference in improvement score was detected in the laser group compared with the peeling group. The epidermal type of melasma was also significantly improved compared with the dermal type (p<0.01). Conclusion: Topical hydroquinone remains the most effective agent for the treatment of melasma in dark‐skinned people with rare side effects.     

Melasma: Treatment strategy

Abstract

Melasma, a hypermelanosis of the face, is a common skin problem of middle-aged women of all racial groups, especially with dark complexion. Its precise etio-pathogenesis is evasive, genetic influences, exposure to sunlight, pregnancy, oral contraceptives, estrogen-progesterone therapies, thyroid dysfunction, cosmetics, and drugs have been proposed. Centro-facial, malar, and mandibular are well-recognized. Epidermal pigmentation appears brown/black, while dermal is blue in color, and can be distinguished by Wood's lamp illumination. The difference may be inapparent with mixed type of melasma in skin types V and VI. An increase in melanin in epidermis: basal and suprabasal layers and/or dermis is the prime defect. There is an increased expression of tyrosinase related protein-1 involved in eumelanin synthesis. The use of broad-spectrum sunscreen is important, lightening agents like retinoic acid (tretinoin), azelaic acid, and combination therapies containing hydroquinone, tretinoin, and corticosteroids, have been used in the treatment of melasma, and are thought to have increased efficacy as compared with monotherapy. Quasi-drugs, placental extracts, ellagic acid, chamomilla extract, butylresorcinol, tranexamic acid, methoxy potassium salicylate, adenosine monophosphate disodium salt, dipropyl-biphenyl-2,2′-diol, (4-hydroxyphenyl)-2-butanol, and tranexamic acid cetyl ester hydrochloride, in addition to kojic and ascorbic acid have been used. Chemical peeling is a good adjunct. Laser treatment is worthwhile.     

A Hydroquinone Solution in the Treatment of Melasma

ABSTRACT: Two versions of a 3% hydroquinone solution in a hydroalcoholic solution were tested in 46 patients with melasma. The more effective of the two solutions tested, Formula A, was found to produce improvement in 88% of the patients, with moderate to marked improvement in 36% of them with minimal side effects. The usage of a sunscreen agent seems to be necessary for therapeutic efficacy.     

What Should Be Considered in Treatment of Melasma

Melasma is a common acquired hyperpigmentary skin disorder characterized by light to dark brown macules and patches occurring in the sun-exposed areas of the face. Melasma lesional skin is characterized by epidermal hyperpigmentation through increased melanogenesis in epidermal melanocytes. Some patients have dermal melanin but its amount is not significant and its distribution is very heterogeneous in the whole melasma lesional skin. Melasma is not homogeneous disease and there are personal characteristics of patients with melasma. The pathogenesis of melasma is not fully understood, but several hypotheses have been suggested. Increased vascularity in melasma lesions has suggested the role of increased number of enlarged vessels in the development of melasma. Endogeneous and exogeneous stimuli such as sex hormones and ultraviolet irradiation respectively may stimulate the microenvironment leading to the release of various mediators that cause activation of melanocytes and/or these stimuli may directly activate the melanocytes. Melasma patients may have specialized melanocytes with an intrinsic sensitivity to these stimuli.     

Melasma: Treatment with 10% tretinoin peeling mask

Background Melasma is one of the most frequently acquired hyperpigmentation disorders clinically characterized by symmetrical brown patches on sun exposed areas. The first approach is an avoidance of sun exposure and inflammation combined with a use of photoprotection. Patient treatment is particularly difficult and challenging, and necessitates consideration of many therapies, including tretinoin to obtain an amelioration of this important skin condition. Aims To evaluate the efficacy of a 10% tretinoin peeling mask before and after treatment using standardized digital photos, mexameter measures, and melasma area and severity index (MASI) evaluation. Patients/Methods The present study was carried out on 20 female patients. Results Physician global evaluation showed moderate or marked improvement of melasma in all patients using three parameters of assessment: digital photography, mexameter measurement, and the MASI. Conclusions Tretinoin peeling mask can be considered an alternative treatment modality in treating melasma. We noted a particular high tolerability and efficacy without adverse events.     

Melasma in men

Melasma is an acquired hypermelanosis that results in localized hyperpigmentation, commonly found on the face. This condition is much more common in women than men. There are some features of melasma in men that seem to differ from those seen in women. However, there is a paucity of data on this topic. The aim of this article is to review the etiology, clinical presentation, and treatment of melasma in men. It is important for dermatologists to understand some unique aspects of melasma in this group to provide appropriate care for patients who suffer from this frustrating condition.     

Melasma in Men

Melasma is characterized by a facial hypermelanosis of light to dark brown color, being more common in women of Hispanic origin. In this study, 27 men with melasma were evaluated clinically and histologically to compare their features with those of previous studies. Three patterns of localization were recognized, namely, centrofacial, malar, and mandibular. On the basis of Wood's light examination, an epidermal, a dermal, and a mixed type were identified. Epidermal hyperpigmentation only and epidermal and dermal hyperpigmentation were found in histologic analysis of the cases. Significant etiologic factors included exposure to sunlight in 66.6% as well as a familial predisposition in 70.4% of the cases. This study demonstrated that melasma in men shares the same clinicohistologic characteristics as in women, but hormonal factors do not seem to play major significant role.     

Melasma of the forearms

Melasma of the forearms seems to be a relatively common sign which is, to our knowledge, not reported in the literature.^1,2 It seems that it may be more common in older patients and especially in postmenopausal women on supplementary oestrogen. The pigmentary change is macular and may be confluent or speckled. Like facial chloasma there is a sharp line of demarcation at the margins. In some, there seems to be an element of erythema.     

Melasma: treatment strategy

Melasma, a hypermelanosis of the face, is a common skin problem of middle-aged women of all racial groups, especially with dark complexion. Its precise etio-pathogenesis is evasive, genetic influences, exposure to sunlight, pregnancy, oral contraceptives, estrogen-progesterone therapies, thyroid dysfunction, cosmetics, and drugs have been proposed. Centro-facial, malar, and mandibular are well-recognized. Epidermal pigmentation appears brown/black, while dermal is blue in color, and can be distinguished by Wood's lamp illumination. The difference may be inapparent with mixed type of melasma in skin types V and VI. An increase in melanin in epidermis: basal and suprabasal layers and/or dermis is the prime defect. There is an increased expression of tyrosinase related protein-1 involved in eumelanin synthesis. The use of broad-spectrum sunscreen is important, lightening agents like retinoic acid (tretinoin), azelaic acid, and combination therapies containing hydroquinone, tretinoin, and corticosteroids, have been used in the treatment of melasma, and are thought to have increased efficacy as compared with monotherapy. Quasi-drugs, placental extracts, ellagic acid, chamomilla extract, butylresorcinol, tranexamic acid, methoxy potassium salicylate, adenosine monophosphate disodium salt, dipropyl-biphenyl-2,2'-diol, (4-hydroxyphenyl)-2-butanol, and tranexamic acid cetyl ester hydrochloride, in addition to kojic and ascorbic acid have been used. Chemical peeling is a good adjunct. Laser treatment is worthwhile.