Wang Jordan V, Christman Mitalee P, Feng Hao, Ferzli Georgina, Jeon Hana, Geronemus Roy G
Laser & Skin Surgery Center of New York, New York, NY, USA.
J Cosmet Dermatol. 2021 Jan;20(1):105-109. doi: 10.1111/jocd.13817. Epub 2020 Nov 11.
Melasma can be associated with immense psychosocial stress, which can impact quality of life. One theory suggests that ultraviolet light can increase plasmin activity in keratinocytes, which has led to the investigation of tranexamic acid for treating melasma, since it possesses anti-plasmin properties. The use of laser-assisted drug delivery can also increase the uptake of topical medications.
A prospective pilot study was performed to assess the utility of combination treatment with low-energy, low-density 1927 nm fractional thulium fiber laser and topical tranexamic acid for melasma.
PATIENTS/METHODS: A total of 10 subjects were enrolled. Each received 5 treatments to the full face with a low-energy, low-density 1927 nm fractional thulium fiber laser. Immediately following treatment, topical tranexamic acid was applied, and subjects were instructed to apply it twice daily for 7 days. Clinical measures, quality of life, and patient satisfaction were assessed.
Mean improvements in Melasma Area and Severity Index (MASI) scores were 1.1 (P = .0899), 3.5 (P = .0395), and 2.5 (P = .2429) at 30-, 90-, and 180-day follow-up, respectively. Maximum improvement occurred at 90-day follow-up. The mean improvement of Melasma Quality of Life Scale (MELASQOL) score was 9.6 (P = .0024) at 30-day follow-up. In addition to changes in pigmentation, subjects also believed their skin felt better, looked more radiant, and had improvements in skin texture and tone.
Combination of low-energy, low-density 1927 nm fractional thulium fiber laser and topical tranexamic acid improved clinical outcomes and quality of life associated with melasma. This combination treatment was safe, well-tolerated, and well-liked by subjects.
黄褐斑可能伴有巨大的心理社会压力，这会影响生活质量。一种理论认为，紫外线可增加角质形成细胞中的纤溶酶活性，这促使人们研究氨甲环酸治疗黄褐斑，因为它具有抗纤溶特性。激光辅助药物递送也可增加局部用药的吸收。
进行一项前瞻性试点研究，以评估低能量、低密度1927纳米分数铥光纤激光与局部氨甲环酸联合治疗黄褐斑的效用。
患者/方法：共纳入10名受试者。每人全脸接受5次低能量、低密度1927纳米分数铥光纤激光治疗。治疗后立即涂抹局部氨甲环酸，并指导受试者每天涂抹两次，持续7天。评估临床指标、生活质量和患者满意度。
在30天、90天和180天随访时，黄褐斑面积和严重程度指数（MASI）评分的平均改善分别为1.1（P = 0.0899）、3.5（P = 0.0395）和2.5（P = 0.2429）。最大改善出现在90天随访时。在30天随访时，黄褐斑生活质量量表（MELASQOL）评分的平均改善为9.6（P = 0.0024）。除色素沉着变化外，受试者还认为他们的皮肤感觉更好、看起来更有光泽，并且皮肤质地和肤色有所改善。
低能量、低密度1927纳米分数铥光纤激光与局部氨甲环酸联合治疗改善了与黄褐斑相关的临床结局和生活质量。这种联合治疗安全、耐受性好且受受试者欢迎。
