Effect of tranexamic acid on melasma: a clinical trial with histological evaluation

Na, Jung Im; Choi, Seo-Young; Yang, Si; Choi, Hyo Geun; Kang, Hee Young; Park, K.-C.

doi:10.1111/j.1468-3083.2012.04464.x

Cited by 187 publications

(187 citation statements)

References 20 publications

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“…TXA has also been reported to suppress neovascularization-induced bFGF [30]. In a recent clinical trial that evaluated the efficacy of systemic TXA in the treatment of melasma, we demonstrated significant decreases in the lesional melanin index and in the erythema index after the oral administration of 250 mg TXA three times per day for eight weeks [31]. Histologic analysis showed significant reductions in the level of epidermal pigmentation and vessel numbers (Figure 2A-D).…”

Section: Increased Vascularizationmentioning

confidence: 88%

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Clues to the Pathogenesis of Melasma from its Histologic Findings

Kwon¹

2014

Pigmentary Disorders

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Section: Increased Vascularizationmentioning

confidence: 88%

“…Mast cells are observed more frequently in melasma skin than in non-lesional skin, especially in the dermal elastotic areas [31] ( Figure 2E-F). The median prevalence of dermal mast cells was significantly higher in melasma skin than in perilesional normal skin (173 ± 57% vs. 145 ± 57%, p=0.04) [8].…”

Section: Mast Cell Prevalencementioning

confidence: 98%

Clues to the Pathogenesis of Melasma from its Histologic Findings

Kwon¹

2014

Pigmentary Disorders

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“…TXA decreases vessel numbers by antagonizing vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (b FGF). Additionally it decreases mast cell numbers [50]. Trials using oral, topical and intralesional TXA in melasma and hyperpigmentation have been performed on TXA alone and in conjunction with other modalities [50][51][52][53].…”

Section: Other Botanicals As Potential Bleaching Agentsmentioning

confidence: 99%

“…Side effects were minimal and all the patients tolerated the treatment well [51]. Na et al (2012) [50] evaluated the efficacy of oral and topical TXA in melasma patients both clinically and histologically. Twenty-five melasma patients were instructed to take TXA tablets (2 tablets tds) and apply the cream twice daily for 8 weeks (each TXA tablet contained 125 mg of TXA, 50 mg of ascorbic acid, 40 mg of L-cysteine, 4 mg of calcium pantothenate and 1 mg of pyridoxine chloride.…”

Section: Other Botanicals As Potential Bleaching Agentsmentioning

confidence: 99%

Melasma, Novel Treatment Modalities

Abdallah¹

2014

Pigmentary Disorders

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Treatment of melasma remains challenging due to frequent relapses and the occurrence of post-inflammatory hyperpigmentation (PIH) following many interventions. Treatment goals are inhibition of melanin synthesis and transfer by sunscreens, sun avoidance and the use of bleaching agents on one hand and removal of already present pigment by peeling, lasers and light on the other hand. Triple combination creams (TCC) (also known as Kligman's formula utilizing hydroquinone and modifications of Kligman's formula) remain the mainstay of treatment. Newer bleaching agents derived from plants and synthetic compounds have been introduced and many of them are promising safe substitutes for hydroquinone.Peeling agents especially superficial and medium depth peels are effective treatment modalities for melasma. Newer peeling agents are less irritating and may thus lead to fewer side effects. Q-switched lasers, which target melanin, have led to PIH until the innovation of "laser toning" and fractional Qswitched ruby, which have better outcomes. Fractional non-ablative and ablative lasers are useful at lower fluencies. Pulsed dye laser, which targets the vascular component in melasma, is promising with less melasma rebound.Combinations of the above-mentioned modalities usually have a better treatment outcome than either alone. This review will focus on the more recently introduced therapies.

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“…Anti-fibrinolytic agents, such as tranexamic acid are therapeutic for melasma 96 . Li et al 97 emphasized that this plasmin inhibitor has a greater effect on the affected melasmic skin than on normal skin and that this was due to the greater amount of vasculature and mast cells in the affected skin.…”

Section: Melasma: a Model Of Incontinencementioning

confidence: 99%

Disorders of Pigmentation of the Skin - Hypotheses Underlying Interventions by Multiple Systems of Medicine:Is there a Role for Integrated Medicine?

Arianayagam

Ryan

2016

Current Science

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Biomedicine has not provided a complete explanation with fully effective therapies for disorders of pigmentation. Biomedicine emphasizes the role of melanocyte for protection from UV rays and as a determinant of skin colour. These important properties acquired a genetic basis much later than other functions, many relating to cell contact as in the keratinocyte -melanocyte unit, or as with the synapses of the neurological system. There are other roles, biochemical and mechanical, of melanocyte. Management that is inclusive of a maximally holistic approach justifies the use of diverse herbals, yoga and concern for cultural awareness provided by integrated medicine. Vitiligo provides a model which demonstrates that Ayurveda has a richer view of its presentations, possibly a stronger line on its pathogenesis, and a huge range of herbals, many now backed by studies from ethnobotanical laboratories, awaiting research into the many possible mechanisms by which they may act in the wide and complex field of melanocyte biochemistry.

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Effect of tranexamic acid on melasma: a clinical trial with histological evaluation

Abstract: TXA decreased epidermal pigmentation associated with melasma and also reversed melasma-related dermal changes, such as vessel number and increased numbers of mast cells.

Cited by 187 publications

References 20 publications

Clues to the Pathogenesis of Melasma from its Histologic Findings

Clues to the Pathogenesis of Melasma from its Histologic Findings

Melasma, Novel Treatment Modalities

Disorders of Pigmentation of the Skin - Hypotheses Underlying Interventions by Multiple Systems of Medicine:Is there a Role for Integrated Medicine?

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