Study of oral tranexamic acid, topical tranexamic acid, and modified Kligman's regimen in treatment of melasma.
Administration, Cutaneous
Administration, Oral
Adolescent
Adult
Drug Combinations
Female
Fluocinolone Acetonide
/ administration & dosage
Follow-Up Studies
Humans
Hydroquinones
/ administration & dosage
Male
Melanosis
/ diagnosis
Middle Aged
Prospective Studies
Severity of Illness Index
Sunscreening Agents
/ administration & dosage
Tranexamic Acid
/ administration & dosage
Treatment Outcome
Tretinoin
/ administration & dosage
Young Adult
MASI score
melasma
modified Kligman's regimen
tranexamic acid
Journal
Journal of cosmetic dermatology
ISSN: 1473-2165
Titre abrégé: J Cosmet Dermatol
Pays: England
ID NLM: 101130964
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
20
03
2020
revised:
01
04
2020
accepted:
02
04
2020
pubmed:
30
4
2020
medline:
9
2
2021
entrez:
30
4
2020
Statut:
ppublish
Résumé
Melasma is a pigmentary disorder affecting mainly face . Various treatment modalities available as topicals, superficial chemical peels and lasers but none till date gives promising results, until date quest for the best treatment modality is on. To study the effect of oral and topical Tranexamic acid (TXA) and modified Kligman's regimen in treatment of melasma. Patients having melasma were enrolled after consent for voluntary participation. A detailed history and clinical examination was done. Total 60 patients were enrolled and randomized in three groups, 20 received oral TXA 250 mg twice daily, 20 topical TXA and 20 received modified Kligman's regimen for 8 weeks along with sunscreen MASI(Melasma area severity index) was calculated at baseline, at end of 4 & 8 weeks. MASI score was compared with that at the end of the study. Based on reduction in mean MASI the therapeutic response was graded. Pre and post treatment photographs was also compared. Statistical analysis done by using student square T test , ANOVA And TUKEY test. Reduction in MASI score was observed in all the groups but greater reduction in MASI score with modified Kligman's regimen by 30% followed with oral TXA by 25% reduction and least with topical TXA by 5%. Although modified Kligman's regimen is comparatively more efficient but due to its side effects in long term usage oral tranexamic acid could be a promising therapeutic approach for melasma.
Sections du résumé
BACKGROUND
BACKGROUND
Melasma is a pigmentary disorder affecting mainly face . Various treatment modalities available as topicals, superficial chemical peels and lasers but none till date gives promising results, until date quest for the best treatment modality is on.
AIM
OBJECTIVE
To study the effect of oral and topical Tranexamic acid (TXA) and modified Kligman's regimen in treatment of melasma.
METHOD
METHODS
Patients having melasma were enrolled after consent for voluntary participation. A detailed history and clinical examination was done. Total 60 patients were enrolled and randomized in three groups, 20 received oral TXA 250 mg twice daily, 20 topical TXA and 20 received modified Kligman's regimen for 8 weeks along with sunscreen MASI(Melasma area severity index) was calculated at baseline, at end of 4 & 8 weeks. MASI score was compared with that at the end of the study. Based on reduction in mean MASI the therapeutic response was graded. Pre and post treatment photographs was also compared. Statistical analysis done by using student square T test , ANOVA And TUKEY test.
RESULTS
RESULTS
Reduction in MASI score was observed in all the groups but greater reduction in MASI score with modified Kligman's regimen by 30% followed with oral TXA by 25% reduction and least with topical TXA by 5%.
CONCLUSION
CONCLUSIONS
Although modified Kligman's regimen is comparatively more efficient but due to its side effects in long term usage oral tranexamic acid could be a promising therapeutic approach for melasma.
Substances chimiques
Drug Combinations
0
Hydroquinones
0
Sunscreening Agents
0
Fluocinolone Acetonide
0CD5FD6S2M
Tretinoin
5688UTC01R
Tranexamic Acid
6T84R30KC1
fluocinolone
CT1IX58L9S
hydroquinone
XV74C1N1AE
Types de publication
Comparative Study
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
1456-1462Informations de copyright
© 2020 Wiley Periodicals, Inc.
Références
Dashore S, Mishra K. Tranexamic acid in melasma: why and how? Indian J Drugs Dermatol. 2017;3:61-63.
Sarkar R, Arora P, Garg VK, Sonthalia S, Gokhale N. Melasma update. Indian Dermatol Online J. 2014;5:426-435.
Padhi T, Pradhan S. Oral tranexamic acid with fluocinolone-based triple combination cream versus fluocinolone-based triple combination cream alone in melasma: an open labeled randomized comparative trial. Indian J Dermatol. 2015;60:520.
Lee HC, Thng TG, Goh CL. Oral tranexamic acid (TA) in the treatment of melasma A retrospective analysis. J Am Acad Dermatol. 2016;75385-75392.
Lakhdar H, Zouhair K, Khadir K, et al. Evaluation of the effectiveness of a broad-spectrum sunscreen in the prevention of chloasma in pregnant women. J Eur Acad Dermatol Venereol. 2007;21(6):738-742.
Bala HR, Lee S, Wong C, Pandya AG, Rodrigues M. Oral tranexamic acid for the treatment of melasma: a review. Dermatol Surg. 2018;44(6):814-825.
Chatterjee M, Vasudevan B. Recent advances in melasma. Pigment Int. 2014;1:70-80.
Maeda K, Tomita Y. Mechanism of the inhibitory effect of tranexamic acid on melanogenesis in cultured human melanocytes in the presence of keratinocyte-conditioned medium. J Health Sci. 2007;53(4):389-396.
Khuraiya S, Kachhawa D, Chouhan B, Dua M, Rao P. A comparative study of topical 5% tranexamic acid and triple combination therapy for the treatment of melasma in Indian population. Pigment Int. 2019;6:18-23.
Cho HH, Choi M, Cho S, Lee JH. Role of oral tranexamic acid in melasma patients treated with IPL and low fluence QS Nd:YAG laser. J Dermatol Treatment. 2011;24(4):292-296.
Wali V, Parwani H. Comparative study of oral tranexamic acid and triple combination versus tranexamic acid through microneedling in patients of melisma. Int J Res Dermatol. 2019;5:537-541.
Boukari F, Jourdan E, Fontas E, et al. Prevention of melasma relapses with sunscreen combining protection against UV and short wavelengths of visible light: a prospective randomized comparative trial. J Am Acad Dermatol. 2015;72(1):189-190.e1.
Atefi N, Dalvand B, Ghassemi M, Mehran G, Heydarian A. Therapeutic effects of topical tranexamic acid in comparison with hydroquinone in treatment of women with melasma. Dermatol Therapy. 2017;7(3):417-424.
Sharma R, Mahajan VK, Mehta KS, Chauhan PS, Rawat R, Shiny TN. Therapeutic efficacy and safety of oral tranexamic acid and that of tranexamic acid local infiltration with microinjections in patients with melasma: a comparative study. Clin Exp Dermatol. 2017;42(7):728-734.