Treatment of refractory melasma with combination of topical 5% magnesium ascorbyl phosphate and fluorescent pulsed light in Asian patients

Shaikh, Zafar Iqbal; Mashood, Ashar A.

doi:10.1111/ijd.12195

Cited by 19 publications

(15 citation statements)

References 32 publications

(72 reference statements)

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“…An extract of C. sinica inhibits dopa auto-oxidation, and α-viniferin interrupts lipid peroxidation via scavenging free radicals and suppresses expression of inflammatory genes in macrophages 19 , 20 , 21 . Numerous antioxidants or anti-inflammatory agents ameliorate melasma, a hyperpigmented disorder in the skin 22 , 23 . In the current study, we investigated the antimelanogenic potential of C. sinica or its active constituent α-viniferin in cAMP-elevated melanocyte cultures or facial hyperpigmented patients, and then elucidated a molecular basis of its action.…”

Section: Introductionmentioning

confidence: 99%

α-Viniferin Improves Facial Hyperpigmentation via Accelerating Feedback Termination of cAMP/PKA-Signaled Phosphorylation Circuit in Facultative Melanogenesis

Yun

Choi

et al. 2018

Theranostics

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Rationale: cAMP up-regulates microphthalmia-associated transcription factor subtype M (MITF-M) and tyrosinase (Tyro) in the generation of heavily pigmented melanosomes. Here, we communicate a therapeutic mechanism of hyperpigmented disorder by α-viniferin, an active constituent of Caragana sinica.Methods: We used cAMP-elevated melanocyte cultures or facial hyperpigmented patches for pigmentation assays, and applied immunoprecipitation, immunobloting, RT-PCR or reporter gene for elucidation of the antimelanogenic mechanism.Results: C. sinica or α-viniferin inhibited melanin production in α-melanocyte-stimulating hormone (α-MSH)-, histamine- or cell-permeable cAMP-activated melanocyte cultures. Moreover, topical application with C. sinica containing α-viniferin, a standard in quality control, decreased melanin index on facial melasma and freckles in patients. As a molecular basis, α-viniferin accelerated protein kinase A (PKA) inactivation via the reassociation between catalytic and regulatory subunits in cAMP-elevated melanocytes, a feedback loop in the melanogenic process. α-Viniferin resultantly inhibited cAMP/PKA-signaled phosphorylation of cAMP-responsive element-binding protein (CREB) coupled with dephosphorylation of cAMP-regulated transcriptional co-activator 1 (CRTC1), thus down-regulating expression of MITF-M or Tyro gene with decreased melanin pigmentation.Conclusion: This study assigned PKA inactivation, a feedback termination in cAMP-induced facultative melanogenesis, as a putative target of α-viniferin in the treatment of melanocyte-specific hyperpigmented disorder. Finally, C. sinica containing α-viniferin was approved as an antimelanogenic agent with topical application in skin hyperpigmentation.

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Section: Introductionmentioning

confidence: 99%

α-Viniferin Improves Facial Hyperpigmentation via Accelerating Feedback Termination of cAMP/PKA-Signaled Phosphorylation Circuit in Facultative Melanogenesis

Yun

Choi

et al. 2018

Theranostics

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“…Because of the risk of PIH in darker skin types with laser and light treatments, Shaikh and Mashood investigated utilizing fluorescent pulsed light (FPL)—a form of IPL with a lower peak power and theoretically lower risk of PIH—with 5% topical magnesium ascorbyl phosphate (MAP)—a stable ester of ascorbic acid that functions as an antioxidant and inhibits melanogenesis. After 12 weeks of treatment, mean MASI scores were significantly reduced.…”

Section: Resultsmentioning

confidence: 99%

Melasma: A critical analysis of clinical trials investigating treatment modalities published in the past 10 years

Spierings

2019

J of Cosmetic Dermatology

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Background: Melasma is an acquired disorder of facial pigmentation which is a treatment challenge.Aims: The aim of this article is to critically appraise the clinical trial evidence for different treatment modalities for melasma, published in peer-reviewed journals in the past 10 years. Patients/Methods: The literature review was conducted using PubMed and MEDLINE. The search was performed in July 2019, and search parameters were limited to all English language articles published in the past 10 years only.Results: Eighty-nine clinical trials were found. Four clinical trials investigated topical hydroquinone, supporting its safety and efficacy as first-line treatment. Twelve studies showed tranexamic acid as very promising. Nineteen studies assessed various novel oral, injectable, and topical treatments and highlight some new potential future treatments. Forty-two studies investigated laser and light treatment in melasma:LFQS laser is still one of the best options, especially in darker skin types. However, the picosecond laser has shown excellent results. Finally, 11 studies looked at peels.Overall, peels have not been shown to be superior to the use of topical therapy alone. Conclusion:Topical therapy with a HQ and retinoid-based product should be first line for a minimum of 3 months with the addition of oral tranexamic acid at 250 mg BD if no contraindication. Second-line treatment with lasers includes the LFQS Nd:YAG, picosecond laser, and the pulsed dye laser in lighter skin types. Third-line therapy would be the addition of chemical peels to the above treatments, with GA or TCA peels having the most evidence for effectiveness. K E Y W O R D Shydroquinone, melasma, pigmentation, tranexamic acid, tretinoin | INTRODUC TI ONMelasma is a common, acquired disorder of facial pigmentation which poses one of the greatest treatment challenges to the dermatologist and the aesthetic practitioner. Clinically, it is characterized by irregular brown macules and patches on the face. 1The exact cause is unknown but risk factors for melasma are wellestablished and include a history of sun exposure as well as exposure to visible light, Fitzpatrick skin types greater than III, pregnancy, the use of exogenous hormones such as the oral contraceptive pill and hormone replacement therapy, as well as a family history. 2 There is also emerging evidence for a significant vascular component in

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“…Medical history, dermoscopic examination to determine melasma type and examination including Fitzpatrick type, were done. Evaluation of PRP and PRP‐IPL outcome was done using (1) Melasma Area and Scoring Index (MASI), 4 modified‐MASI (mMASI) for each side, and (2) patient's and physician satisfaction at baseline, 2, 4, 6 weeks and 1 month after treatment according to a 4‐point scoring scale 5 …”

Section: Methodsmentioning

confidence: 99%

Study of autologous platelet‐rich‐plasma versus its combination with intense pulsed light in treatment of melasma

Adel

Serri

El-Raheem

2021

Dermatologic Therapy

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Melasma is a common acquired hypermelanosis of variably successful therapies with frequent relapse. Platelet-rich-plasma (PRP) is a promising treatment in melasma, alone or combined with other treatments. We evaluated efficacy of autologous PRP in melasma treatment and the effect of combined intense pulsed light (IPL). Study included 20 Egyptian female melasma patients. PRP was injected in all melasma area and IPL was used on the right hemi-face. Melasma Area and Scoring Index (MASI) of melasma area, modified-MASI (mMASI) of PRP-IPL side and of PRP side significantly decreased after treatments (p-value < 0.05). There was no statistically significant difference between both sides regarding mMASI score or patient and physician satisfaction (p-value > 0.05). Our study provides the first comparison between PRP versus its combination with IPL in melasma treatment. We think the improvement of melasma with regression of melasma scores after PRP treatment is an important finding.

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Treatment of refractory melasma with combination of topical 5% magnesium ascorbyl phosphate and fluorescent pulsed light in Asian patients

Abstract: Combination of 5% MAP with FPL is effective, well tolerated, and safe in treating refractory melasma in Asian patients but for persistent improvement, maintenance treatments would be required.

Cited by 19 publications

References 32 publications

α-Viniferin Improves Facial Hyperpigmentation via Accelerating Feedback Termination of cAMP/PKA-Signaled Phosphorylation Circuit in Facultative Melanogenesis

α-Viniferin Improves Facial Hyperpigmentation via Accelerating Feedback Termination of cAMP/PKA-Signaled Phosphorylation Circuit in Facultative Melanogenesis

Melasma: A critical analysis of clinical trials investigating treatment modalities published in the past 10 years

Study of autologous platelet‐rich‐plasma versus its combination with intense pulsed light in treatment of melasma

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