For chloasma with mild symptoms, general treatment such as sunscreen or medication such as depigmentant or systemic treatment such as oral tranexamic acid should be carried out.
1. General treatment: Ultraviolet rays in sunlight can lead to the activation of pigment cell function, and long-term irradiation can damage the epidermal barrier, increase the activity of tyrosinase in melanocytes, and promote the synthesis and transit of melanin. It is recommended that patients should use ≥30 sunscreen in conjunction with daily outings. Use skin care products with moisturizing and anti-allergic effects to increase the skin’s own tolerance.
2. Medication: Because chloasma has a certain family genetic tendency, decolorizing agents such as L-vitamin C and 4% tretinoin can be used, which have inhibitory effects. Clinically, hydroquinone and its glycoside derivatives are mostly used for treatment, and common deoxyarbutin and arbutin are glucose derivatives of hydroquinone, which are less irritating to the local area.
3. Systemic therapy: systemic drug therapy oral vitamin C, E and tranexamic acid.
Tranexamic acid can improve melasma by inhibiting the stimulation of melanocytes by some cytokines; secondly, Tranexamic acid and tyrosine are similar in chemical structure, which can compete with tyrosine for tyrosinase and then interfere with the catalytic effect of tyrosinase on tyrosine metabolism, so as to achieve the reduction of melanin synthesizing enzyme.
The above medication should be administered under strict medical supervision. The same disease, the patient’s physical condition is different, different stages of the disease, the treatment method is different, should be standardized under the guidance of a doctor.