Efficacy of gold microneedle combined with tranexamic acid transdermal administration for treatment of post-inflammatory hyperpigmentation from acne vulgaris / 中华医学美学美容杂志

Objective:To evaluate the efficacy of gold microneedle combined with tranexamic acid transdermal administration for the treatment of post-inflammatory hyperpigmentation caused by acne vulgaris.Methods:From January 2022 to October 2022, 36 patients with post-inflammatory hyperpigmentation of facial acne who went to the Laser Medical Center, Air Force Medical Center were treated, including 10 males and 26 females, with 21-42 (28.3±4.8) years of age. The patients were divided into observation group and control group, with 18 cases in each group. The observation group was treated with gold microneedle combined with transdermal administration of tranexamic acid, the control group with 0.5 mm microneedles combined with transdermal administration of tranexamic acid. Both groups were treated for 2 times with an interval of 2 months. The total effective rate, post acne hyperpigmentation index (PAHPI), UV spots, brown spots, pores, skin texture, and adverse reaction were evaluated at 4 weeks after the last treatment.Results:Clinical observation was completed in all 36 patients. In the observation group, 17 cases were effective, accounting for 94.4%, and in the control group, 11 cases were effective, accounting for 61.1%, The curative effect of the observation group was better than that of the control group, and the difference between the two groups was statistically significant ( P<0.05). The differences in PAHPI score, UV spots, brown spots, pores, and skin texture between the two groups were also statistically significant ( t=3.10, 2.52, 2.71, 2.43 and 3.54; P=0.004, 0.017, 0.001, 0.021 and 0.001). The patiens in both groups had different degrees of burning sensation, erythema, edema. dryness and other symptoms after treatment, which were relieved 3 days after treatment without special treatmet. Conclusions:Gold microneedle plus transdermal administrationof tranexamic acid is a safe and effective method for the treatment of post-inflammatory pigmentation caused by acne vulgaris.

Effect of urea-extracted sericin on melanogenesis: potential applications in post-inflammatory hyperpigmentation

BACKGROUND: Hyperpigmentation disorders such as post-inflammatory hyperpigmentation are major concerns not only in light-skinned people but also in Asian populations with darker skin. The anti-tyrosinase and immunomodulatory effects of sericin have been known for decades. However, the therapeutic effects of sericin on hyperpigmentation disorders have not been well documented. METHODS: In this study, we used an in vitro model to study the anti-tyrosinase, tolerogenic, and anti-melanogenic effects of sericin on Staphylococcus aureus peptidoglycan (PEG)-stimulated melanocytes, dendritic cells (DCs), and artificial skin (MelanoDerm™). Enzyme-linked immunosorbent assay, conventional and immunolabeled electron microscopy, and histopathological studies were performed. RESULTS: The results revealed that urea-extracted sericin has strong anti-tyrosinase properties as shown by a reduction of tyrosinase activity in melanin pigments both 48 h and 10 days after allergic induction with PEG. Anti-inflammatory cytokines including interleukin (IL)-4, IL-10, and transforming growth factor-p were upregulated upon sericin treatment (10, 20, and 50 µg/mL), whereas production of allergic chemokines, CCL8 and CCL18, by DCs was diminished 48 h after allergic induction with PEG. Moreover, sericin lowered the expression of micropthalmia-associated transcription factor (MITF), a marker of melanogenesis regulation, in melanocytes and keratinocytes, which contributed to the reduction of melanin size and the magnitude of melanin deposition. However, sericin had no effect on melanin transport between melanocytes and keratinocytes, as demonstrated by a high retention of cytoskeletal components. CONCLUSION: In summary, sericin suppresses melanogenesis by inhibition of tyrosinase activity, reduction of inflammation and allergy, and modulation of MITF function.

Combined vitamin C sonophoresis and neodymium-doped yttrium aluminum garnet (NdYAG) laser for facial hyperpigmentation: An outcome observation study in Asian patients.

Background: The neodymium-doped yttrium aluminum garnet (NdYAG) laser therapy has been a popular technique for facial rejuvenation but certain adverse effects like post-infl ammatory hyperpigmentation are issues of concern to Asian patients. Aims: To assess the outcome following combined treatment with vitamin C sonophoresis and NdYAG laser, in selected cases of facial hyperpigmentation. Methods: Twenty three women with dyschromia or melasma who had undergone fi ve sessions of Q-switched NdYAG laser therapy followed by transdermal delivery of vitamin C via sonophoresis were selected after a retrospective review of case records. The objective and subjective clinical outcomes and the side effects, including erythema, scaling, pruritus, dryness and post-infl ammatory hyperpigmentation were evaluated. Results: In both objective or subjective outcomes, 91.3% (21/23) of the patients showed an excellent or better outcome, while 8.7% (2/23) showed no change. A majority of the patients (73.9%, 17/23) experienced no post-infl ammatory hyperpigmentation or had slight post-infl ammatory hyperpigmentation which quickly resolved within 1 week. Only one (4.3%) patient had extreme post-infl ammatory hyperpigmentation which lasted for over a month. Limitations: This was a retrospective study without a control group; a comparative study with a control group (patients treated with the laser alone, without vitamin C sonopheresis) is needed to determine the difference in the outcome. Conclusion: The use of vitamin C sonophoresis along with NdYAG laser may reduce the incidence of adverse effects in Asian patients. Patients experienced obvious improvement in hyperpigmentation and had lower chances of experiencing extreme or severe post-inflammatory hyperpigmentation.