Comparison of efficacy and safety of tranexamic acid mesotherapy versus oral tranexamic acid in patients with melasma undergoing Q‐switched fractional 1064‐nm Nd:YAG laser: A blinded RCT and follow‐up

Behrangi, Elham; Shemshadi, Mahsa; Ghassemi, Mohammadreza; Goodarzi, Azadeh; Dilmaghani, Sara

doi:10.1111/jocd.14496

Cited by 9 publications

(9 citation statements)

References 26 publications

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“…In this study, patients with melasma were studied by two methods, Nd‐Yag Fraction 1064 + microinjection of TA and Nd‐Yag Fraction 1064+ oral TA. The result of this study showed that there is no significant relationship between micro injection and oral methods but the oral use of TA is much more tolerable for patients 31 …”

Section: Discussionmentioning

confidence: 77%

“…The result of this study showed that there is no significant relationship between micro injection and oral methods but the oral use of TA is much more tolerable for patients. 31 As mentioned, TA can affect vascular component of skin and its effects on skin manifestations of rosacea was shown in a study conducted in 2019. It was found that application of TA can have significant effects on the erythema of rosacea and the severity score of rosacea significantly improved.…”

Section: Discussionmentioning

confidence: 92%

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Evaluating the effect of tranexamic acid as mesotherapy on persistent post‐acne erythema: A before and after study

Sadeghzadeh‐Bazargan

Ziaeifar

Abouie

et al. 2023

J of Cosmetic Dermatology

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BackgroundAcne vulgaris is a common skin disease that is more common in young population and it can be associated with some sequels after resolving the lesions. Post‐inflammatory erythema is one of these complications that can be disturbing for patients and does not have any definite treatment. This study was aimed to evaluate the efficacy and safety of tranexamic acid (TA) as mesotherapy in treatment of post‐acne erythema (PAE) treatment.MethodThis clinical trial study was performed in the dermatology clinic on 17 patients with persistent PAE (3 months after acne recovery). Two sessions of treatment were performed by a physician with 2‐week intervals; TA was injected as mesotherapy into the right side of each patient's face as the case group, while the opposite side was used as the control group. A Visioface device was used to compare before and after treatment photographs of each side of the face in color mode with quantitative measures such as lesions count, area, and area percent.ResultsFinally, 15 patients completed treatment sessions. There were statistically significant differences in right side lesions before and after treatment with p‐values of 0.047, 0.002, and 0.035 for count, area, and area percent, respectively. There was no significant difference before and after treatment in terms of count, area. and area‐percent on the left side.ConclusionAccording to the results of this study, TA injection as mesotherapy for resolving PAE can be effective. However, due to small sample size, further studies are needed.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 92%

Evaluating the effect of tranexamic acid as mesotherapy on persistent post‐acne erythema: A before and after study

Sadeghzadeh‐Bazargan

Ziaeifar

Abouie

et al. 2023

J of Cosmetic Dermatology

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“…Then, by screening the titles and abstracts, we further eliminated 793 studies. Ultimately, 39 randomized clinical trials 12,18–55 were included in the network meta‐analysis. The flowchart of screening and selection is depicted in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of laser‐related therapy for melasma: A systematic review and network meta‐analysis

Ma,

Gao,

Liu

et al. 2023

J of Cosmetic Dermatology

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BackgroundMelasma is a prevalent, persistent hyperpigmentation disorder that negatively affects the psychological health of patients. However, the treatment outcome remains unsatisfactory due to the complexity of pathogenesis, recurrence characteristics, and relatively high morbidity.ObjectivesTo compare the performance of laser‐related therapies in improving the melasma area severity index (MASI) score of melasma and the occurrence of adverse effects by network meta‐analysis (NMA).MethodsFrom the inception to November 2022, eligible randomized controlled trials were identified. Two investigators independently searched relevant studies from PUBMED, EMBASE, and the Cochrane Library database.ResultsA total of 39 clinical studies with 1394 participants were eligible for enrollment. For efficacy, the NMA demonstrated that Q‐switched Nd: YAG laser + topical medications (QSND+TM) was superior to Q‐switched Nd:YAG laser (QSND) [MD = −4.21 (−6.80, −1.63)], Er: YAG laser + topical medications (ERYL+TM) [MD = ‐3.52 (−6.84, −0.19)], and picosecond laser + topical medications (PICO+TM) [MD = −4.80 (−9.33, −0.27)]. The microneedling + topical medications (MN+TM) was superior to picosecond laser (PICO) [MD = −5.26 (−10.44, −0.08)] and topical medications (TM) [MD = −5.22 (−9.20, −1.23)]. The top five of the surface under the cumulative ranking curve value (SUCRA) are Q‐switched Nd:YAG laser + topical medications (QSND+TM 85.9%), oral tranexamic acid (oTA 80.1%), microneedling + topical medications (MN+TM 79.7%), Q‐switched Nd:YAG laser + intense pulse light (QSND+IPL 78.9%), and fractional carbon dioxide laser + topical medications (FCDL+TM 70.5%).ConclusionsIn conclusion, the Qs‐Nd:YAG laser with topical medications is the first choice for treating melasma according to the SUCRA value. Among the three treatment modalities, namely MN + TM, PICO, and TM, our recommendation favors MN+TM as the superior choice for enhancing the curative efficacy in melasma. However, the actual clinical choice should also take into account the adverse effects, the skin type of the patient, the duration of the disease, and other relevant factors.

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“…Pigment particles quickly expand and burst after absorbing enormous laser energy in an instant, and the cellular framework can be thoroughly preserved and repaired 26 . After being broken, pigment particles are gradually swallowed up by phagocytes and discharged from the body, resulting in the decrease of local pigment in lesions 27,28 . At the same time, the thermal energy generated by the interaction between laser and human tissue is effectively limited in the target tissue, thus avoiding the thermal damage of surrounding tissues 29 .…”

Section: Discussionmentioning

confidence: 99%

Q‐switched 1064 nm Nd: YAG laser restores skin photoageing by activating autophagy by TGFβ1 and ITGB1

Xiang,

Jia,

Duan

et al. 2024

Experimental Dermatology

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Excessive ultraviolet B ray (UVB) exposure to sunlight results in skin photoageing. Our previous research showed that a Q‐switched 1064 nm Nd: YAG laser can alleviate skin barrier damage through miR‐24‐3p. However, the role of autophagy in the laser treatment of skin photoageing is still unclear. This study aims to investigate whether autophagy is involved in the mechanism of Q‐switched 1064 nm Nd: YAG in the treatment of skin ageing. In vitro, primary human dermal fibroblast (HDF) cells were irradiated with different doses of UVB to establish a cell model of skin photoageing. In vivo, SKH‐1 hairless mice were irradiated with UVB to establish a skin photoageing mouse model and irradiated with laser. The oxidative stress and autophagy levels were detected by western blot, immunofluorescence and flow cytometer. String was used to predict the interaction protein of TGF‐β1, and CO‐IP and GST‐pull down were used to detect the binding relationship between TGFβ1 and ITGB1. In vitro, UVB irradiation reduced HDF cell viability, arrested cell cycle, induced cell senescence and oxidative stress compared with the control group. Laser treatment reversed cell viability, senescence and oxidative stress induced by UVB irradiation and activated autophagy. Autophagy agonists or inhibitors can enhance or attenuate the changes induced by laser treatment, respectively. In vivo, UVB irradiation caused hyperkeratosis, dermis destruction, collagen fibres reduction, increased cellular senescence and activation of oxidative stress in hairless mice. Laser treatment thinned the stratum corneum of skin tissue, increased collagen synthesis and autophagy in the dermis, and decreased the level of oxidative stress. Autophagy agonist rapamycin and autophagy inhibitor 3‐methyladenine (3‐MA) can enhance or attenuate the effects of laser treatment on the skin, respectively. Also, we identified a direct interaction between TGFB1 and ITGB1 and participated in laser irradiation‐activated autophagy, thereby inhibiting UVB‐mediated oxidative stress further reducing skin ageing. Q‐switched 1064 nm Nd: YAG laser treatment inhibited UVB‐induced oxidative stress and restored skin photoageing by activating autophagy, and TGFβ1 and ITGB1 directly incorporated and participated in this process.

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Comparison of efficacy and safety of tranexamic acid mesotherapy versus oral tranexamic acid in patients with melasma undergoing Q‐switched fractional 1064‐nm Nd:YAG laser: A blinded RCT and follow‐up

Cited by 9 publications

References 26 publications

Evaluating the effect of tranexamic acid as mesotherapy on persistent post‐acne erythema: A before and after study

Evaluating the effect of tranexamic acid as mesotherapy on persistent post‐acne erythema: A before and after study

Efficacy and safety of laser‐related therapy for melasma: A systematic review and network meta‐analysis

Q‐switched 1064 nm Nd: YAG laser restores skin photoageing by activating autophagy by TGFβ1 and ITGB1

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