Melasma - 黄褐斑https://en.wikipedia.org/wiki/Melasma
黄褐斑 (Melasma) 是指面部皮肤呈棕褐色或深色。黄褐斑被认为是由阳光照射、遗传倾向、激素变化和皮肤刺激引起的。尽管它可以影响任何人,但在女性中尤为常见,尤其是孕妇以及正在服用避孕药或激素替代治疗药物的女性。

黄褐斑是一种色素持续产生的疾病,不能仅靠一定时间的激光治疗来根除。Tranexamic acid(氨甲环酸) 有助于改善并减少色素沉着。

治疗
在一些国家(例如日本、韩国),口服Tranexamic acid(氨甲环酸) 可在柜台购买且有效。含有Tranexamic acid(氨甲环酸)和Azelaic acid(壬二酸)的黄褐斑霜可能有一定帮助。Hydroquinone(对苯二酚) 可局部用于治疗色素沉着过度,但 FDA 自 2020 年起已停止销售含有 Hydroquinone(对苯二酚) 的 OTC 产品。
#Tranexamic acid [TRANSINO]

#Laser toning technique (low fluence QS1064 laser)
#Triluma
☆ 德国 Stiftung Warentest 2022 年的结果显示,消费者对 ModelDerm 的满意度仅略低于付费远程医疗咨询。
  • 这是 40 岁出头的亚洲女性的常见病症。照片中圈出的病变更接近雀斑而不是黄褐斑。
    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 
    NIH
    最近, low-fluence Q-switched Nd:YAG (LFQSNY) 激光治疗黄褐斑变得流行,尤其是在亚洲。总结各种研究具有挑战性,但与传统疗法相比,LFQSNY 似乎对黄褐斑普遍有效且安全。然而,据报道,一些斑驳的色素减退病例是 LFQSNY 的副作用,可能是由于高激光能量造成的。过度使用 LFQSNY 还会导致炎症引起的色素沉着过度,尤其是深色肤色。
    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
    色素沉着问题经常在初级保健中被发现。常见的色素沉着过度疾病包括:post-inflammatory hyperpigmentation(炎症后色素沉着)、melasma(黄褐斑)、sunspots(日晒斑)、freckles(雀斑)和café au lait spots(咖啡牛奶斑)。
    Pigmentation problems are often found in primary care. Common types of hyperpigmentation disorders include post-inflammatory hyperpigmentation, melasma, sunspots, freckles, café au lait spots.