Role of different topical modalities in improvement of facial hyperpigmentation and skin rejuvenation
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20194683Keywords:
Kojic acid, Azelaic acid, 4-n-butyl resorcinol, Tranexamic acid, GlutathioneAbstract
Background: Facial hypermelanosis is a psychologically stressful condition for modern men and women who are cosmetically more conscious than their ancestors. There are various lightening agent used for several months before effect becomes apparent and are much more effective when pigment is epidermal. these topical agents include hydroquinone, liquorice derivatives niacinamide, glycolic acid, arbutin and deoxyarbutin, ascorbic acid, 4-n-butyl resorcinol, retinoids topical steroids mequinol, kojic acid, azelaic acid, 5% tranexmic acid, glutathione cream etc.
Methods: A randomized, controlled study was done. 220 patients were given either treatment will be given depending upon the physician choice after taking well informed consent from the patient. Patients' assessment regarding the degree of improvement of complexion since the beginning of therapy was evaluated.
Results: The percentage satisfactory response for different modalities was as follow kojic acid 2% cream- 55.55%, 20% azelaic acid cream- 53.12%, 4-n-butyl resorcinol 0.3% cream- 57.89%, 5% tranexmic acid lotion- 48.83% and glutathione cream- 55.76%.
Conclusions: Out 220 patients post inflammatory hyperpigmentation was the most common facial condition. Total 61 patients of PIH were there in the present study including 26 males and 35 females followed by melasma. All The modalities were effective in the treatment of different types- pigmentary conditions.
References
Nijo T. Treatment of melasma with tranexamic acid. Clin Res. 1979;13:3129-31.
Hölzle E. Pigmented lesions as a sign of photodamage. Br J Dermatol. 1992;127(41):4850.
Ber RS, Bhawan J. Lentigo. Int J Dermatol 1996;35:229-39.
Bastiaens M, Hoefnagel J, Westendorp R, Vermeer BJ, Bouwes Bavinck JN. Solar lentigines arestrongly related to sun exposure in contrast to ephelides. Pigment Cell Res. 2004;17:225-9.
Dubin N, Pasternack BS, Moseson M. Simultaneous assessment of risk factors for malignant melanoma and nonmelanoma skin lesions, with emphasis on sun exposure and related variables. Int J Epidemiol 1990;19:811-9.
Green A, Battistutta D. Incidence and determinants of skin cancer in a highrisk Australian population. Int J Cancer. 1990;46:356-61.
Kricker A, Armstrong BK, English DR, Heenan PJ. Pigmentary and cutaneous risk factors for non-melanocytic skin cancer – A case control study. Int J Cancer. 1991;48:650-62.
Mehregan AH. Lentigo senilis and its evolutions. J Invest Dermatol. 1975;65:429-33.
Yamada T, Hasegawa S, Inoue Y, Date Y, Arima M, Yagami A, et al. Comprehensive analysis ofmelanogenesis and proliferation potential of melanocyte lineage in solar lentigines. J Dermatol Sci. 2014;73:251-7.
Scott G, Leopardi S, Printup S, Malhi N, Seiberg M, Lapoint R.. Proteinase-activated receptor-2 stimulates prostaglandin production in keratinocytes: analysis of prostaglandin receptors on human melanocytes and effects of PGE2 and PGF2a on melanocytes dendricity. J Invest Dermatol. 2004;122:1214-24.
Ransom M, Posen S, Mason RS. Human melanocytes as a target tissue for hormones:in vitro studies with la-25, dihydroxy-vitamin D3, a-melanocyte stimulating hormone, and p-estradiol. J Invest Dermatol. 1988;91:593-8.
Friedmann PS, Gilchrest BA. Ultraviolet radiation directly induces pigment production by cultured human melanocytes. J Cell Physiol. 1987;133:88-94.
Abdel-Malek Z, Swope V, Smalara D. Analysis of the UV-induced melanogenesis and growth arrest in human melanocytes. Pig Cell Res. 1994;7:326-32.
Wu S, Shi H, Wu H, Yan S, Guo J, Sun Y, et al. Treatment of melisma with oral administration of tranexamic acid. Aesthetic Plast Surg 2012;36:964‑70.
Kondou S, Okada Y, Tomita Y. Clinical study of effect of tranexamic acid emulsion on melasma and freckles. Skin Res 2007;6:309‑15.
Lin CB, Hu Y, Rossetti D, Chen N, David C, Slominski A, et al. Immunohistochemical evaluation of solar lentigines: The association of KGF/KGFR and other factors with lesion development. J DermatolSci 2010;59:917.
Kanechorn Na Ayuthaya P, Niumphradit N, Manosroi A, Nakakes A. Topical 5% tranexamic acid for the treatment of melasma in Asians: A double‑blind randomized controlled clinical trial. J Cosmet Laser Ther 2012;14:150-4.
Gilchrist BA, Fitzpatrick TB, Anderson RR et al: Localization of melanin pigmentation in the skin with wood's lamp. Br J Dermatol. 1977;96:245-8.
Breathnach AS. Electron microscopy of melanocytes and melanosomes in freckled human epidermis. J Invest Dermatol. 1964;42:389-94.
