Melasma - 肝斑
40代前半のアジア人女性によく見られる症状です。写真の丸で囲った病変は肝斑というより黒子に近いです。
References
Tranexamic acid is a novel treatment option for melasma; however, there is no consensus on its use. This systematic review searched major databases for relevant publications to March 2016. Eleven studies with 667 participants were included. Pooled data from tranexamic acid-only observational studies with pre- and post-treatment Melasma Area and Severity Index (MASI) showed a decrease of 1.60 in MASI after treat?ment with tranexamic acid. The addition of tranexamic acid to routine treatment modalities resulted in a further decrease in MASI of 0.94. These results support the efficacy and safety of tranexamic acid, either alone or as an adjuvant to routine treatment modalities for melasma.
最近、 low-fluence Q-switched Nd:YAG (LFQSNY) レーザーは、特にアジアで肝斑の治療に人気があります。多様な研究を要約するのは困難でしたが、LFQSNY は従来の治療法と比較して肝斑に対して一般的に効果的で安全であるようです。ただし、LFQSNY の副作用として、おそらく高いレーザーエネルギーが原因で、斑状の色素沈着低下が発生するケースがいくつか報告されています。 LFQSNY を積極的に使用すると、特に肌の色が濃い場合に、炎症による色素沈着過剰を引き起こす可能性があります。
Recently, the low-fluence Q-switched Nd:YAG laser (LFQSNY) has been widely used for treating melasma, especially in Asia. It was hard to summarize the heterogenous studies, but LFQSNY appeared to be a generally effective and safe treatment for melasma considering the results of previous conventional therapies. However, mottled hypopigmentation has been occasionally reported to develop and persist as an adverse event of LFQSNY, which may be associated with the high accumulated laser energy. When used aggressively, even LFQSNY can induce hyperpigmentation via unwanted inflammation, especially in darker skin.
Recently, the low-fluence Q-switched Nd:YAG laser (LFQSNY) has been widely used for treating melasma, especially in Asia. It was hard to summarize the heterogenous studies, but LFQSNY appeared to be a generally effective and safe treatment for melasma considering the results of previous conventional therapies. However, mottled hypopigmentation has been occasionally reported to develop and persist as an adverse event of LFQSNY, which may be associated with the high accumulated laser energy. When used aggressively, even LFQSNY can induce hyperpigmentation via unwanted inflammation, especially in darker skin.
色素沈着の問題はプライマリケアで見つかることがよくあります。一般的な色素沈着過剰症には post-inflammatory hyperpigmentation, melasma, sunspots, freckles, and café au lait spots が含まれます。
Pigmentation problems are often found in primary care. Common types of hyperpigmentation disorders include post-inflammatory hyperpigmentation, melasma, sunspots, freckles, café au lait spots.
Pigmentation problems are often found in primary care. Common types of hyperpigmentation disorders include post-inflammatory hyperpigmentation, melasma, sunspots, freckles, café au lait spots.
肝斑は色素が生成され続ける病気のため、一定期間のレーザー治療では治りません。トラクセネム酸は、色素沈着を軽減するのに役立ちます。
○ 処理
一部の国（日本、韓国など）では、経口トラネキサム酸が店頭で入手でき、効果があります。トラネキサム酸とアゼライン酸を配合した肝斑クリームが部分的に役立つ場合があります。
ハイドロキノンは色素沈着過剰の治療に局所的に使用される可能性がありますが、FDAは2020年時点でハイドロキノンを含むOTC製品の販売を停止しました。
#Tranexamic acid [TRANSINO]
#Laser toning technique (low fluence QS1064 laser)
#Triluma