Clinical evaluation of efficacy and tolerability of cysteamine 5% cream in comparison with tranexamic acid mesotherapy i
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ORIGINAL PAPER
Clinical evaluation of efficacy and tolerability of cysteamine 5% cream in comparison with tranexamic acid mesotherapy in subjects with melasma: a single‑blind, randomized clinical trial study Maryam Karrabi1 · Mohammad Ali Mansournia2 · Ehsan Sharestanaki3 · Yeganeh Abdollahnejad4 · Mohammad Sahebkar4,5 Received: 9 March 2020 / Revised: 31 July 2020 / Accepted: 26 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract This study was aimed at evaluating the efficacy of Tranexamic Acid (TA) mesotherapy versus cysteamine 5% cream in the treatment of melasma. This single-blind, randomized clinical trial was conducted among 54 subjects between 2018 and 2019. Cysteamine 5% cream group was instructed to apply the cream on the melasma lesions 30 min before bed for 4 consecutive months. Conversely, 0.05 mL (4 mg/mL) TA mesotherapy was performed by a physician every 4 weeks until 2 months. The severity of melasma was evaluated using both Dermacatch® device and the modified Melasma Area Severity Index (mMASI). The most remarkable improvement rate was observed in the TA group at the third visit based on mMASI and Dermacatch® values at 47% and 15% in turn. The mMASI scores were substantially improved in both groups at the second visit (cysteamine vs TA 8.48 ± 2.34 and 7.03 ± 3.19; P = 0.359) and third visit (cysteamine vs TA 6.32 ± 2.11 and 5.52 ± 2.55; P = 0.952) as compared to baseline (cysteamine vs TA: 11.68 ± 2.70 and 10.43 ± 2.69). Dermacatch® values were significantly declined at the second and third visits (cysteamine vs TA 42.54 ± 12.84 and 38.75 ± 9.80, P = 0.365; 40.74 ± 12.61 and 36.17 ± 10.3, P = 0.123, respectively) compared with baseline (cysteamine vs TA 45.76 ± 13.41 and 42.41 ± 10.48), although the improvement rates between two groups were not significantly different. Findings suggest that none of the cysteamine and TA mesotherapy treatments measured by both mMASI and Dermacatch® methods have substantial advantages over the other; however, complications are less in the cysteamine than the TA mesotherapy group. Keywords Tranexamic acid (TA) · Mesotherapy · Cysteamine · Melasma · Iran
Introduction Melasma is a common hyperpigmentary disorder of the skin that appears as light brown to dark spots with unclear borders [1]. These spots appear on areas of the skin that are exposed to sunlight, including the cheeks, forehead, upper lip, nose, chin, and sometimes neck [1]. The prevalence of
melasma varies widely between 8.8 and 40% depending on ethnicity, skin phototype, and intensity of sun exposure [2, 3]. Melasma occurs in both sexes; however, it is more prevalent in women, especially in fertile and dark-skinned women such as Hispanics, Latinos, Asians, and African Americans [4]. The underlying causes of melasma are unclear; however, some influencing factors include genetic factors, exposure
* Mohammad Sahebkar [email protected]
1
Department of Dermatology, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
Maryam Karrabi M
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