Efficacy and safety of intralesional steroid injection in the treatment of melasma

Abstract

Melasma is an acquired disorder of pigmentation that affects different ethnic groups with high prevalence among pigmented phenotypes. It presents as symmetric brown or grayish black patches and macules on sun-exposed areas especially face. Neck and chest are less frequently affected. 1 It is usually associated with a negative impact on the psychological state and the quality of life of affected patients. 2,3 The definite etiopathogenesis of melasma is not completely known. Genetic predisposition is a major factor in the pathogenesis of melasma besides sun exposure and hormonal factors of pregnancy or estrogen and progesterone therapy. 4 Melanocytes hyperactivity with excess melanin production is the main pathological finding in melasma. In addition to, disruption of the basement membrane by the effect of matrix metalloproteinase (MMP)-2 and MMP-9 has been found to be elevated in the lesional areas, with subsequent facilitation of the descent of active

Topical and Systemic Therapies in Melasma: A Systematic Review

“…TCC is found to be comparable in efficacy to intralesional tranexamic acid (TXA) and intralesional triamcinolone acetonide[ 21 22 23 ] TCC in combination with laser therapy yields better results than either therapy alone. [ 24 25 26 27 28 29 30 31 32 ]…”

Safety and efficacy of mesotherapy in the treatment of melasma: A review article

“…Other lightening agents including triamcinolone, vitamin C, and glutathione have been used as mesotherapy for melasma. Triamcinolone reduces melanogenesis through inhibition of inflammatory mediators 35,36 . Two clinical trials found significant reduction of MASI score at the end of treatment with ID microinjections of triamcinolone (4 mg/cc) and Kligman’s formulation with no significant difference between the two groups 35,36 .…”

“…Triamcinolone reduces melanogenesis through inhibition of inflammatory mediators 35,36 . Two clinical trials found significant reduction of MASI score at the end of treatment with ID microinjections of triamcinolone (4 mg/cc) and Kligman’s formulation with no significant difference between the two groups 35,36 . Atrophy and mild telangiectasia were observed in 4.76% of the cases and were improved spontaneously and with one session of pulsed dye laser (PDL), respectively 35…”

“…Application of ice‐pack after mesotherapy for several hours can be used to mitigate erythema and swelling. Occasionally, adverse effects such as acne formation (6.4%), PIH (8.3%), stuffy feeling (5.8%), and abscesses formation (2.5%) were reported 21,31,33,36 …”

“…35,36 Two clinical trials found significant reduction of MASI score at the end of treatment with ID microinjections of triamcinolone (4 mg/cc) and Kligman's formulation with no significant difference between the two groups. 35,36 Atrophy and mild telangiectasia were observed in 4.76% of the cases and were improved spontaneously and with one session of pulsed dye laser (PDL), respectively. 35 Ascorbic acid or vitamin C has antioxidant and anti-inflammatory effects and inhibits tyrosinase enzyme by competing with copper at active site.…”