International Journal of Health and Clinical Research
Yazarlar: Vimala Manne, Anchala Parthasaradhi
Konular:-
Anahtar Kelimeler:Melasma,Oral Tranexamic acid,Oral Antioxidants,Topical steroid abuse,Vitamin C,Niacinamide,Ed,Range complex,Polypodium Leucotomos(PL),Silymarin.
Özet: Melasma is a common dermatological pigmentary disorder that can be very difficult to treat. Topical bleaching agents and stringent photoprotection, along with other treatment modalities, such as chemical peels and laser treatments, have been shown to provide only minimal improvements in this dyspigmentation. Of late, tranexamic acid has shown promise. Usage of different formulations of tranexamic acid-like topical, intradermal, and oral have been studied for Melasma, with oral formulations demonstrating the highest, although temporary, improvement. The efficacy of oral Tranexamic acid in the daily dose of 500mg for 3 to 6 months in Melasma patients has been established in various studies. Documented evidence of side effects with a higher dose of Tranexamic acid is present. There are also many published articles on the efficacy of oral sunscreens and antioxidants in preventing the exacerbation of Melasma in various studies. Topical corticosteroids (TCS) are widely misused on face especially by patients of refractory Melasma. Such patients cannot tolerate topical creams with strong bleaching agents. There are many topical agents which help in the treatment of Melasma without using topical steroids or strong bleaching agents like Hydroquinone which are misused by the rural population who visit our DVL outpatient department. Oral Tranexamic acid at a dose of 500 mg in 2 divided doses will give a response but recurrence after stopping the drug after 6 months usage occurs. In this study oral Tranexamic acid dose has been reduced and an oral antioxidant like Vitamin C, Lycopene, Red Orange Complex, Polypodium Leucotomos has been added in refractory Melasma patients to reduce the side effects of oral Tranexamic acid and without compromising its efficacy, as an adjunct in the treatment of Melasma; along with the use of broad spectrum sunscreen spf 50 plus which blocks both Ultraviolet radiation and visible light and milder topical agents containing Silymarin, PteroWhite, Soy extract, Niacinamide, Kojic acid and Mandelic acid which can be well tolerated on patients with a history of steroid abuse delivering promising results.