Melasma - 肝斑肝斑
肝斑 (Melasma) は、顔の黄褐色または褐色肌の変色です。肝斑は、日光への曝露、遺伝的素因、ホルモンの変化、皮膚の炎症によって引き起こされると考えられています。誰でも罹患する可能性がありますが、特に女性、特に妊婦や避妊薬やホルモン補充療法薬を服用している女性によく見られます。


#Tranexamic acid [TRANSINO]

#Laser toning technique (low fluence QS1064 laser)
  • 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 Efficacy and Safety of Tranexamic Acid in Melasma: A Meta-analysis and Systematic Review 28374042
    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.
     The Low-Fluence Q-Switched Nd:YAG Laser Treatment for Melasma: A Systematic Review 35888655 
    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.
     Pigmentation Disorders: Diagnosis and Management 29431372
    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.