Melasma is very difficult to treat, and there is not yet an effective means of eradication. The following are several common prevention and treatment methods.
1.General measures
(1) Avoid sun exposure
Since it has been confirmed that ultraviolet radiation will lead to melanin increase, avoiding sun exposure can avoid the aggravation of melasma and ensure the treatment effect of melasma. You must use shading tools or sunscreen when you are outdoors.
(2) Reduce stimulation
Try to reduce the stimulation of facial skin, especially the vigorous rubbing of the pigmented parts, and must gently wash the face and reduce the massage care of the face. Many melasma patients tend to make up and remove makeup repeatedly on the lesioned area, which is a kind of stimulation to melasma and causes further deterioration of melasma.
(3) Reduce cosmetics
Try to reduce the use of cosmetics, especially avoiding the use of fragrant and irritating cosmetics.
(4) Stop using contraceptive pills
Melasma will be reduced after some patients stop using contraceptive pills.
2.Systemic medication
(1) Tranexamic acid
Tranexamic acid is a kind of blood clotting drug, which is found to have the effect of treating melasma by chance when it is used clinically. Tranexamic acid was first used in Japan for the treatment of melasma, and the earliest academic paper was published in 1979, and it has been used for more than 30 years. Clinical studies have confirmed that both oral administration and intradermal injection can effectively treat melasma, while the whitening effect of intravenous injection has not been confirmed in academic studies. Although tranexamic acid is very effective in treating melasma, its therapeutic mechanism is still unknown and may be related to the inhibition of tyrosinase.
(2) Vitamin C, glutathione
Both of these drugs can inhibit melanin formation and are often applied as auxiliary drugs. Currently, Japan has developed an OTC product for melasma treatment: TRANSINO®, which contains tranexamic acid and vitamin C and glutathione, with better effect than tranexamic acid alone.
(3) Plant extracts
Such as Centella asiatica glucoside, green tea extract, Salvia officinalis extract, glycyrrhizin, Kawarazin, etc., all have the effect of inhibiting melanin formation.
(4) Traditional Chinese Medicine (TCM)
Traditional Chinese medicine generally uses formulae such as Peach Red Four Objects Soup to treat melasma by tonifying the kidneys, draining the liver and harmonizing the qi and blood to achieve the effect of resolving blood stasis and eliminating spots.
3.Topical drug treatment
Various kinds of depigmenting agents, the most commonly used one is hydroquinone, which has been the first choice of topical medication for melasma treatment, but it is difficult to control the concentration of use, and it is easy to produce secondary pigmentation after medication, especially yellow people are prone to this complication. Other topical medications include chemical exfoliators such as retinoic acid, azelaic acid, glycolic acid and lactic acid, which can also have therapeutic effects on melasma. The efficacy of topical drug treatment is relatively unstable for Asian people, and it is easy to produce adverse consequences such as dermatitis, skin atrophy and aggravation of pigmentation.
4.Laser treatment
The effect of laser treatment for melasma is not exact, and the reported results are different. Generally, Q-switched laser and fractional laser are mostly used to treat pigmentation. For some relatively superficial melasma, there may be certain effect, but for deep melasma, it is difficult to achieve good effect, and if the parameters of laser are larger, it may even cause secondary pigmentation, so generally speaking, do not try to use laser treatment for melasma rashly.