ascorbic-acid and Melanosis

Vitamin C is a micronutrient present in high concentrations in normal skin and a highly prescribed cosmeceutical, well known for protecting against ultraviolet-induced pigmentation and regulating collagen production. However, there is a lack of studies evaluating the efficacy of topical vitamin C in photoaging and melasma, with this systematic review being the first to assess the existing evidence.. This systematic review aims to assess whether topical vitamin C could be effective in reversing photoaging signs and treating melasma.. Prospective, randomized controlled trials assessing protocols with topically applied vitamin C in patients with melasma or photodamage were searched in Medline, CENTRAL, and Scopus databases until the 12th of May 2022. Risk of bias was conducted in accordance with Cochrane Collaboration's tool for assessing the risk of bias in randomized trials, using RevMan 5.0.. Seven publications were included, with 139 volunteers in total. Studies that evaluated the topography of skin indicated that the treated skin appeared smoother and less wrinkled, which was supported by biopsies data. On objective assessments of pigmentation, there was a significant lightening of the skin treated. Hydration improved equally in the vitamin C and placebo-treated sites.. This study revealed that vitamin C is effective in treating uneven, wrinkled skin and has depigmenting properties, but long-term use may be needed to achieve noticeable changes. Q-switched Nd:YAG laser-associated protocols appear beneficial in enhancing vitamin C effects. Topical vitamin C may be a suitable alternative for melasma and photoaging, but more studies are needed to confirm these results and assess the ideal vitamin C concentration.

Topics: Ascorbic Acid; Humans; Lasers, Solid-State; Melanosis; Prospective Studies; Skin; Skin Aging; Treatment Outcome; Vitamins

Mesotherapy is a popular novel therapeutic modality that is defined as intradermal or subcutaneous microinjection of pharmaceutical compounds. Although this novel treatment method is used commonly in aesthetic dermatology, there is little information about details of injections, efficacy, and side effects of mesotherapy in melasma.. In this review, we evaluated efficacy and safety of various types of mesotherapy in the treatment of melasma.. We searched Google Scholar, Medline, and PubMed for related articles with keywords "melasma" OR "chloasma" AND "mesotherapy" OR "injection." Inclusion criteria were articles that evaluated intradermal injection of lightening drugs and published dates between January 2000 and September 2021. Exclusion criteria were articles in languages other than English or non-human studies.. Thirty-three articles evaluated efficacy of mesotherapy in melasma, including 28 articles about tranexamic acid, 4 articles about vitamin C, 2 articles about glutathione, and 2 articles about triamcinolone.. Mesotherapy is a good alternative or adjunctive choice in patients who are refractory to first-line therapy, patients with low compliance with everyday use of topical therapy, patients with contraindication to oral tranexamic acid therapy, or who wish short downtime and fast recovery period. Further studies with large sample sizes are required to determine ideal concentrations of mesotherapy substances and intervals between sessions and to evaluate the efficacy of different substances for mesotherapy as monotherapy compared to combination therapy and other treatment modalities for melasma.

Topics: Ascorbic Acid; Chemexfoliation; Humans; Melanosis; Mesotherapy; Tranexamic Acid; Treatment Outcome

Melasma is common, chronic and treatment-challenging cosmetic concern and the aim of this study was to systematically evaluate clinical studies assessing the treatment of melasma through needling while focusing on efficiency, safety, and recurrence.. After e-search a total of 54 articles were reviewed and 12 published articles (February 2011-September 2020) in terms of content, topic, and purpose, were finalized. Articles were open pilot trials, case reports, case series, retrospective studies, quasi-experimental trials, randomized clinical trials, and split face comparative studies.. The highest decrease in MASI score was 85.71% and allocated to microneedling method following only 3 sessions with an interval of 30 days. On the other hand, the lowest decrease in this score was 3.7% and allocated to microneedling treatment and its use for vitamin C delivery at the end of the fourth week of treatment. No side effects were reported in included studies, and the various needling methods used were safe. Recurrence after treatment was reported in none of these articles, and only one of them reported a 4% recurrence in the second phase of treatment, but no recurrence was reported in the last phase of that study.. Non-aggressive microneedling with topical depigmenting agents was more effective than topical depigmenting agents alone, so that the mean MASI score was significantly higher than those who used lightening serum alone. So needling can be suggested as an effective and safe method with low recurrence rate for the treatment of melasma.

Topics: Administration, Cutaneous; Ascorbic Acid; Humans; Melanosis; Retrospective Studies; Skin Lightening Preparations; Treatment Outcome

Microneedling as an adjuvant to topical medications has shown promising but variable results in the treatment of melasma.. To conduct a systematic review and meta-analysis on the efficacy of microneedling as an adjuvant to topical therapies for the treatment of melasma.. This study followed PRISMA guidelines. All comparative, prospective studies on the use of topical interventions with microneedling for the treatment of melasma were included. Studies involving radiofrequency microneedling were excluded.. Twelve eligible studies comprising 459 patients from 7 different countries were included. Topical therapies included topical tranexamic acid, vitamin C, platelet-rich plasma, non-hydroquinone-based depigmentation serums, and hydroquinone-based depigmenting agents. Topical therapy with microneedling improved melasma severity with a large effect (standardized mean difference >0.8) beyond 8 weeks, with best results seen at 12 weeks. Compared to topical therapy alone, topical therapy with microneedling resulted in an additional improvement in melasma severity with a moderate effect at 8 weeks and a large effect at 12-16 weeks. Microneedling was well tolerated across studies, with no serious adverse events reported.. Heterogeneity in study designs did not allow for a comparison of the efficacy of various topical therapies with microneedling.. Microneedling is useful adjuvant to topical therapies for the treatment of melasma.

Topics: Administration, Cutaneous; Ascorbic Acid; Humans; Melanosis; Prospective Studies; Tranexamic Acid; Treatment Outcome

Melasma is a common acquired disorder of hyperpigmentation that commonly affects those with skin of color. Tranexamic acid (TXA) is a novel treatment for melasma that has a multimodal mechanism of action.. To provide a comprehensive review of the literature regarding the evidence on the mode of action, safety profile, and efficacy of TXA in the treatment of melasma.. The literature was searched for publications on TXA in the treatment of melasma using MEDLINE, Scopus, and Google Scholar.. Oral TXA has clearly demonstrated the efficacy for melasma in Asian skin, even in low doses (e.g., 500 mg daily) over short periods (8-12 weeks). It is also a safe therapeutic option, which is easy to administer with few and mild side effects. Studies have shown that TXA does not increase the thromboembolic risk, although patients should be screened carefully for contraindications and risk factors prior to commencement of the therapy.. Oral TXA is a safe and efficacious treatment for refractory melasma. It should be considered in cases that are unresponsive to topical hydroquinone and combination topical therapy over a period of approximately 12 weeks and without contraindications to oral TXA.

Topics: Administration, Oral; Ascorbic Acid; Dermatologic Agents; Evidence-Based Medicine; Humans; Melanosis; Tranexamic Acid; Treatment Outcome; Vitamin B Complex; Vitamin E

This article reviews an old drug tranexamic acid to its new use in the treatment of melasma. Its mechanism of preventing the activation of melanocyte from UV light, hormone and injured kerationcyte through the inhibition of the plasminogen activator system will be explored. The detail usage for such indication and its safety profile will also be thoroughly evaluated.

Topics: Administration, Oral; Ascorbic Acid; Dermatologic Agents; Drug Therapy, Combination; Humans; Melanosis; Tranexamic Acid; Treatment Outcome; Vitamin B Complex; Vitamin E; Vitamins

Melasma is a common acquired symmetrically distributed hyperpigmented macules of sun-exposed skin. Skin microneedling acts as a transdermal delivery system that facilitates the penetration of lightening agents to deeper layers of skin.. Clinical and dermoscopic evaluation of the efficacy and safety of topical tranexamic acid versus topical vitamin C after microneedling for melasma treatment.. Twenty patients with facial melasma were enrolled in a split-face prospective, randomized uncontrolled study. The right side of the face was treated with topical tranexamic acid after dermapen microneedling, while the left side of the face was treated with topical vitamin C after dermapen microneedling. Sessions were done every 2 weeks for 6 sessions. The Hemi-MASI score and dermoscopic examination before and after treatment were done.. Hemi-MASI score was reduced after treatment on both sides of the face, besides improvement of the pigmented lesions showed by dermoscopy on both sides and improvement of the vascular component on the tranexamic acid treated side.. Topical tranexamic acid or vitamin C application after dermapen microneedling was an effective and safe technique in melasma treatment with minimal side effects, and vascular component improvement by tranexamic acid.

Topics: Administration, Cutaneous; Ascorbic Acid; Humans; Melanosis; Prospective Studies; Tranexamic Acid; Treatment Outcome; Vitamins

Ascorbic acid (vitamin C) is an antioxidant that is widely used in cosmetics in skincare products. Due to the excessive low stability of ascorbic acid in cosmetic formulations, the stabilized ascorbic acid derivative, magnesium ascorbyl phosphate (MAP) was formulated as vesicular carriers; ethosomes and niosomes. The aim was to deliver MAP at the intended site of action, the skin, for sufficient time with enhanced permeation to get an effective response. Ethosomes were formulated using a full 3

Topics: Administration, Cutaneous; Adult; Animals; Antineoplastic Agents; Ascorbic Acid; Chemistry, Pharmaceutical; Dose-Response Relationship, Drug; Drug Carriers; Drug Liberation; Drug Stability; Female; Gels; Humans; Liposomes; Male; Melanosis; Middle Aged; Neurocutaneous Syndromes; Rats; Surface Properties

Few safe and effective treatments are available for melasma. Cysteamine, a non-melanocytotoxic molecule is a safer alternative to hydroquinone and usable for long-term use.. To evaluate the effect of cysteamine 5% cream in the treatment of melasma.. Sixty-five of 80 patients completed this single-blind, randomized, controlled trial. The patients received cysteamine 5% or hydroquinone 4%/ascorbic acid 3% (HC) cream. The therapeutic response was evaluated by modified MASI (mMASI) and melanin index (SkinColorCatch) after 2 and 4 months of treatment. The effect of treatment on the quality of life was also assessed.. The decrease in mMASI score was from 6.69 ± 2.96 to 4.47 ± 2.16 in the cysteamine group and from 6.26 ± 3.25 to 3.87 ± 2.00 in the HC group after 4 months (p values < 0.001). The melanin index decreased from 37.72 ± 10.17 to 31.47 ± 11.90 in the cysteamine group and from 36.37 ± 10.80 to 23.16 ± 8.83 in the HC group after 4 months (p-value = 0.003 and <0.001, respectively). The difference between mMASI score at baseline and month 4 was not significant between both groups (p-value > 0.05). The difference between the melanin index at baseline and month 4 was significantly more pronounced in the HC group (p-value = 0.002). Quality of life improved in both groups (p-value < 0.05), but was not significantly different between groups (p-value > 0.05).. Cysteamine was confirmed to be an effective treatment for melasma, with equivalent results to HC in reducing mMASI score and improving quality of life, despite lesser melanin index reduction observed. Cysteamine and HC efficacy was confirmed in patients recalcitrant to previous treatments, by a significant reduction of mMASI and melanin index.

Topics: Ascorbic Acid; Cysteamine; Emollients; Humans; Hydroquinones; Melanins; Melanosis; Quality of Life; Single-Blind Method; Treatment Outcome

Melasma is a benign and chronic hypermelanosis characterized by irregular light brown to dark brown patches of hyperpigmentation on the skin. Oral tranexamic acid (TA) or vitamin C (VC) supplementation has been one treatment choice. TA interferes with keratinocyte-melanocyte interactions, and VC functions by reducing melanin production resulting in skin rejuvenation and whitening.. The aim of the present study was to compare the efficacy and safety of Myjet assisted transdermal injection of TA vs VC in the treatment of melasma.. In this split-face controlled trial, 17 patients were randomized to receive eight weekly transdermal injections of TA or VC via Myjet either on the right or the left side of their face. MASI was measured from each side of the face at the baseline, at the middle, and at the end of treatment.. A reduction in MASI was observed for TA and VC separately (P value < 0.05). The difference in efficacy between TA and VC group was not statistically significant (P value 0.05). Both treatments were well tolerated, with no serious adverse events reported.. Weekly TA or VC transdermal injections can be an effective treatment for melasma. Further studies are required to validate these findings.

Topics: Adult; Ascorbic Acid; Drug Therapy, Combination; Face; Female; Humans; Image Processing, Computer-Assisted; Injections, Subcutaneous; Male; Melanosis; Middle Aged; Patient Satisfaction; Photography; Prospective Studies; Severity of Illness Index; Skin; Skin Pigmentation; Tranexamic Acid; Treatment Outcome

Melasma is a distressing condition for both dermatologists and patients. We evaluated the effectiveness of salicylic acid (SA) peel and vitamin C mesotherapy in the treatment of melasma.. Fifty female patients were divided into two groups. All patients were treated with 30% SA peel every two weeks for two months. In addition, after SA peeling Group A was intradermally administered 10 vitamin C on the melasma lesion at 1-cm intervals. All patients were followed up for 6 months, during which the recurrence rates were evaluated. Digital photographs of the melasma site were taken and patients' Melasma Area and Severity Index (MASI) scores were assessed. After the treatment, the patients were asked to complete the melasma quality of life questionnaire (MelasQoL) to evaluate their satisfaction with the treatment. All the adverse effects were noted.. The MelasQoL and MASI scores of patients in both groups significantly decreased after the treatment. Apart from a burning sensation, no adverse event was observed and all patients tolerated the treatment well.. SA peel combined with vitamin C mesotherapy is a safe and effective alternative for the treatment of melasma with no significant side effects and minimal downtime.

Topics: Adult; Antioxidants; Ascorbic Acid; Chemexfoliation; Combined Modality Therapy; Female; Humans; Keratolytic Agents; Melanosis; Mesotherapy; Middle Aged; Photography; Prospective Studies; Quality of Life; Salicylic Acid; Severity of Illness Index; Single-Blind Method; Young Adult

High recurrence has previously been reported in the treatment of melasma with low-fluence 1,064-nm Q-switched neodymium-doped yttrium aluminium garnet (QS-Nd:YAG) laser. On the other hand, the efficacy and safety of the QS-Nd:YAG laser plus microneedling with vitamin C have not been evaluated in patients with mixed-type melasma.. Sixteen patients with recalcitrant dermal- or mixed-type melasma were included in the study. One side of patients' face was treated with QS-Nd:YAG laser plus microneedling with vitamin C (Group A) and the other side with QS-Nd:YAG laser alone (Group B) for four sessions at four-week intervals. Melasma Area Severity Index (MASI) scores and clinician's evaluation of clinical response were assessed monthly.. Group A had a significantly lower mean MASI score and better treatment response than Group B according to clinician's evaluation. According to MASI scores, in Group B, two patients had a good response while 12 were unresponsive to treatment. Good or very good improvement was reported by 10 patients in Group A and three patients in Group B. Adverse effects and recurrence rates were similar in Groups A and B (31.3 and 43.8%, respectively).. QS-Nd:YAG increases the blood circulation in the dermis, thereby enhancing the mechanical effect of microneedling to promote the penetration of vitamin C.. Vitamin C application with microneedling immediately after treatment with QS-Nd:YAG laser is a promising adjunctive method for the treatment of recalcitrant melasma.

Topics: Adult; Antioxidants; Ascorbic Acid; Combined Modality Therapy; Cosmetic Techniques; Double-Blind Method; Erythema; Facial Dermatoses; Female; Humans; Hyperpigmentation; Hypopigmentation; Lasers, Solid-State; Male; Melanosis; Middle Aged; Needles; Quality of Life; Recurrence; Retreatment; Severity of Illness Index

Melasma is a common acquired and distressing pigmentary disorder presenting to dermatology clinics. It is notably difficult to cure and has a tendency to relapse. The efficacy of classical Q-switched laser in treatment of melasma remains controversial. This study aims to investigate the efficacy and safety of 694-nm fractional QSRL combined with sonophoresis on levorotatory vitamin C for the treatment of melasma patients. Twenty-six patients with melasma were enrolled. Each patient received four to six fractional QSRL treatments at pulse energies of 2.5 to 4 J/cm(2) combined with sonophoresis on levorotatory vitamin C at 2-week intervals. The severity and the area of melasma were assessed by two investigators using the melasma area and severity index (MASI). Side effects were documented. Mean MASI score decreased from 15.51 ± 3.00 before treatment to 10.02 ± 4.39 3 months after the final treatment (P < 0.01). Side effects were few and transient. High-density coverage fractional QSRL combined with sonophoresis on levorotatory vitamin C is safe and effective for the treatment of melasma in Chinese patients.

Topics: Adult; Ascorbic Acid; Asian People; Combined Modality Therapy; Female; Humans; Lasers, Solid-State; Low-Level Light Therapy; Male; Melanosis; Middle Aged; Ultrasonic Therapy

Periorbital Melanosis (POM) is a very common esthetic condition, yet there is no definite treatment modality. Topical therapy is the mainstay of treatment which includes chemical peels, vitamin C, and other depigmenting agents.. To compare clinical efficacy, safety, and tolerability of 20% glycolic acid peels, 15% lactic acid peels, and topical 20% vitamin C in treatment of constitutional type of POM in Indian patients.. Ninety patients of constitutional POM were enrolled for 12 weeks. The patients were distributed into three groups. One-third of patients underwent 3-weekly GA peel, another one-third underwent 3-weekly lactic peel, and rest applied vitamin C daily. Clinical improvement was assessed objectively using POM grading. Patient's and physicians global assessment along with patient's global tolerance was also evaluated.. More than 50% improvement in POM was observed in 73.34% of patients on GA peel, 56.67% on lactic peel, and 26.67% on vitamin C. On comparing improvement with respect to duration of therapy, GA peel was significantly more effective than lactic peel from 12 weeks onward, while it was more effective than vitamin C from 6 weeks onward. Lactic peel was more effective than vitamin C from 6 weeks onward. Physician and patient global assessment was excellent with glycolic peel followed by lactic peel and vitamin C. The incidence of adverse effect was maximum with GA peel followed by lactic peel and vitamin C.. Glycolic peel was best among the three modalities, although it was associated with increased rate of side effects.

Topics: Administration, Cutaneous; Adult; Antioxidants; Ascorbic Acid; Chemexfoliation; Eye; Facial Dermatoses; Female; Glycolates; Humans; Keratolytic Agents; Lactic Acid; Male; Melanosis; Prospective Studies; Time Factors; Treatment Outcome; Young Adult

To compare the efficacy in terms of reduction in melasma area and severity index (MASI) score by more than 10 of a combination of 20% trichloro-acetic acid peel plus 5% topical magnesium ascorbyl phosphate versus 20% trichloroacetic acid peel alone in the treatment of epidermal melasma.. Randomized controlled trial.. Department of Dermatology, Lady Reading Hospital (LRH), Peshawar, from May 2012 to May 2013.. Patients aged 18 - 65 years, with Fitzpatrick skin type III-V were divided into two equal groups having 74 patients each. Detailed history was taken and Wood's lamp examination done to rule out mixed and dermal melasma. Melasma area and severity index (MASI) score was calculated for every patient. Priming was done for all patients with tretinoin cream applied once daily at night for 2 weeks, and to use a broad spectrum sun block cream before sun exposure. Patients in group Awere subjected to combined treatment, i.e. trichloro-acetic acid peel 20% (weekly) plus magnesium ascorbyl phosphate cream (applied once daily), while patients in group B were subjected to trichloro-acetic acid peel 20% (weekly) alone. Treatment was continued for 6 weeks. After completion of treatment, MASI score was recalculated. Proportion of patients with significant MASI score reduction was compared using chi-square test with significance at p < 0.05.. Male and female patients were 11 (14.9%) and 63 (85.1%), respectively in group A, whereas 13 (17.6%) and 61 (82.4%) in group B. The mean age in group Awas 30.28 ±8.08 years, and 29.36 ±6.84 years in group B. Significant MASI score reduction in group Awas seen in 60 (81.1%) patients and in group B 49 (66.2%, p= 0.040).. Combination of trichloro-acetic acid peel and topical magnesium ascorbyl phosphate cream was significantly more effective than trichloro-acetic acid peel alone in treatment of melasma.

Topics: Administration, Cutaneous; Adult; Aged; Ascorbic Acid; Chemexfoliation; Dermatologic Agents; Drug Therapy, Combination; Female; Humans; Keratolytic Agents; Magnesium; Male; Melanosis; Middle Aged; Severity of Illness Index; Treatment Outcome; Trichloroacetic Acid; Young Adult

Melasma is an acquired pigment disorder showing symmetrical hyperpigmentation of the face characterized by light to dark brown patches with indistinct borders on both cheeks. Melasma is prevalent in middle-aged women with harmless hormone imbalances. It is also known as the mask of pregnancy and is prevalent in most child-bearing women. It fluctuates month by month, and yet, there is no promising treatment. The Q-switched neodymium-doped yttrium aluminum garnet (QS-Nd:YAG) laser (1,064-nm wavelength) was introduced in Asia years ago for both skin toning and treatment of facial pigment. This low-fluence, 1,064-nm QS-Nd: YAG laser also reportedly improved melasma. Adjunctive treatments such as vitamin C iontophoresis or chemical peels were recommended in other reports. The technique using the 1,064-nm QS-Nd:YAG laser for toning and the enhancement of adjunctive treatments need further investigation and long-term follow-up before recommendations for the ideal protocol for melasma treatment can be made. The aim of this study is to evaluate the improvement of melasma using different parameters with the 1,064-nm QS-Nd:YAG laser with ultrasonic application of topical vitamin C. Eight patients, ranging in age from 32 to 45 years (mean 37 years), with long-term melasma were studied. Most of the melasma cases were dermal or mixed-type melasma. The patients had no cosmetic treatment (laser, intense pulsed light, or chemical peel) 1 year prior to the study. The entire face of each patient was treated with the 1,064-nm QS-Nd:YAG laser for four sessions at 1-month intervals. The laser treatment was divided into three parts with different parameters. First, each patient underwent whole face exposure for one pass with an 8-mm spot size at a power of 2.0 J/cm(2). Next, the spot size was shifted to 6 mm at a power of 3.5 J/cm(2) for one full-face pass, and then ended with a 4-mm spot size at 3.2 J/cm(2) for one full-face pass, with multiple passes for the main lesions. The end point was mild erythema and swelling, without petechiae. All patients applied ice packs for 5 min before the adjunctive treatment. We designed a split-face study with or without ultrasonic application of topical vitamin C. Only the right side of the face received ultrasonic melasma application of vitamin C for 15 min after ice packing. The left side of the face was covered with a moisturizing lotion. Objective evaluation was performed with visual analog score. All eight patients completed the 3-month

Topics: Administration, Topical; Adult; Ascorbic Acid; Combined Modality Therapy; Female; Humans; Lasers, Solid-State; Low-Level Light Therapy; Melanosis; Middle Aged; Treatment Outcome

Melasma is an acquired disorder of hypermelanosis of great psychosocial concern. The treatments with various conventional therapies are often unsatisfactory. Lasers and light sources have been used to treat pigmented lesions, but in Asian skin with higher melanin content, such treatments may be challenging.. To determine the effectiveness of treating melasma with a combination of topical 5% magnesium ascorbyl phosphate (MAP) and fluorescent pulsed light (FPL).. Patients of skin types III-V with refractory melasma were treated for 12 weeks with topical application of 5% MAP and three sessions of FPL (570-950 nm) at 3, 6, and 9 weeks (fluence 12-14 J/cm(2) , pulse width 15 ms, and spot size 3 cm(2) ). They were followed up for another 12 weeks to assess the persistence of treatment benefit. Digital photographs of the patients were taken at each visit. Treatment efficacy was determined by calculating mean melasma area and severity index (MASI) at the beginning and then at weeks 6, 12, and 24. The subjective assessment was done by comparing pre-treatment and post-treatment photographs by an independent observer and self-assessment by patients using four-point scoring scale (1, poor, 2, fair, 3, good, and 4, excellent).. Sixty-five patients completed the study. The baseline mean MASI score of 14.80 decreased to 4.53 at the 12th week (end of treatment) and 6.35 at the 24th week (end of follow-up). The overall regression of mean MASI at these end-points was 69.3% and 57% (P < 0.01). The pre- and post-treatment photographic evaluation by independent observer and patients' self-assessment at the 12th week showed good to excellent response (scores 3 and 4) in 52.3% and 44.6% cases, respectively. No significant adverse effects of treatment were noted.. Combination of 5% MAP with FPL is effective, well tolerated, and safe in treating refractory melasma in Asian patients but for persistent improvement, maintenance treatments would be required.

Topics: Administration, Topical; Adolescent; Adult; Antineoplastic Agents; Ascorbic Acid; Asian People; Combined Modality Therapy; Female; Fluorescence; Follow-Up Studies; Humans; Male; Melanosis; Phototherapy; Treatment Outcome; Young Adult

Facial skin pigmentary disorders can be resistant to conventional treatment. Superficial chemical peel is an effective and safe treatment in pigmentary problems including melasma, post-inflammatory hyperpigmentation and aging spots.. To assess the efficacy and safety of new superficial chemical peel (Melasma peel, Theraderm®), this is composed of alpha-hydroxy acid (AHAs), vitamin C and oxygen for melasma.. Twenty-five ethnic Korean patients (Fitzpatrick skin phototypes IV and V) with moderate to severe melasma were enrolled. The patients underwent four treatments at 1-2-week intervals for 8 weeks. Clinical improvement was evaluated on a 5-point scale by participants and by the same dermatologist, and adverse effects were checked during the study.. Improvement in the degree of pigmentation, pores, and evenness were noted. Significant clinical improvement of hyperpigmentation was evident. No adverse effects were reported.. New superficial chemical peel using AHAs, vitamin C and oxygen is an effective and very safe treatment for melasma.

Topics: Adult; Ascorbic Acid; Asian People; Chemexfoliation; Face; Female; Humans; Hydroxy Acids; Male; Melanosis; Middle Aged; Patient Satisfaction; Republic of Korea

A common, disfiguring problem in women, melasma is often refractory to treatment, and long-term remissions are difficult to achieve. This study assessed the safety and effectiveness of a procedure combining microdermabrasion, a topical regimen, and low fluence Q-switched Nd:YAG laser treatment.. In this observational study of 27 female subjects, phototypes II-V, referred for treatment of mixed-type melasma refractory to previous therapies, low-fluence QS Nd:YAG laser treatment of 1.6-2 J/cm(2) with 5 or 6 mm spot was administered immediately following microdermabrasion. Daily application of a broad-spectrum sunscreen began immediately; subjects used a topical skin care regimen of hydroquinone with tretinoin or vitamin C. Treatments were repeated at 4-week intervals. Follow-up assessment was done 3-12 months after the last treatment. Adverse effects were recorded at each visit. Standardized digital photographs obtained before each treatment session and at follow-up visits were objectively assessed by blinded comparison using a quartile grading system.. Treatment was successful in all skin types, deemed painless by all subjects, and required no anesthesia. Average number of treatments was 2.6. Twenty-two subjects (81%) had >75% clearance of melasma; 11 subjects (40%) achieved >95% clearance. Most subjects showed >50% clearance of their melasma 1 month after the first treatment. Side effects were limited to mild post-treatment erythema, which developed after the microdermabrasion and lasted approximately 30-60 minutes. Four subjects noted temporary exacerbation of melasma after inadvertent sun exposure, but this resolved within several weeks of resuming the topical skin care regime. Remission lasted at least 6 months.. Microdermabrasion plus low-fluence QS Nd:YAG laser treatment is a simple, non-invasive procedure with minimal risk, no recovery time, and long-lasting remission. Treatment works on all skin phototypes in just two to three treatment sessions. Subject compliance with skin care was excellent, probably due to the dramatic improvement observed within 4 weeks.

Topics: Adult; Antioxidants; Ascorbic Acid; Combined Modality Therapy; Dermabrasion; Female; Follow-Up Studies; Humans; Hydroquinones; Keratolytic Agents; Lasers; Lasers, Solid-State; Melanosis; Middle Aged; Single-Blind Method; Sunscreening Agents; Treatment Outcome; Tretinoin

  Melasma is a common pigmentary disorder. Despite the availability of a wide range of skin-lightening treatments, melasma of skin remains a therapeutic challenge..   The aim of this study was to evaluate the efficacy and safety of nanosome vitamin C iontophoresis and to compare the therapeutic effects of nanosome vitamin C iontophoresis vs. glycolic acid peel 70% in the treatment of melasma in Egyptian women..   This study included 14 patients of melasma with skin type IV-V taken for a right-left comparison study of six sessions. Glycolic acid 70% peel was applied on the right side, whereas nanosome vitamin C was applied by iontophoresis on the other side. The results are evaluated using the melasma area and severity index score and with photographs at baseline and after six sessions. Also the photographs were evaluated by two single-blinded physicians before and after sessions..   Both sides were improved, but the side treated with nanosome vitamin C showed better results. Side effects were few and transient..   We concluded that nanosome vitamin C is a new, safe and effective, easy and painless method in the treatment of melasma.

Topics: Adult; Antioxidants; Ascorbic Acid; Chemexfoliation; Female; Glycolates; Humans; Iontophoresis; Keratolytic Agents; Liposomes; Melanosis; Middle Aged; Nanoparticles; Severity of Illness Index; Single-Blind Method

To study the effect of Gan-Pi regulatory needling (GPRN) in treating chloasma and its influences on female sex hormones, superoxide dismutase (SOD), lipid peroxide (LPO) and melanocyte-stimulating hormone (MSH).. Ninety chloasma patients were equally randomized to three groups, the treatment group treated with GPRN, the control group treated with conventional Western medicine and the blank group untreated. Changes in the scores of skin lesion (area and color) and symptom, as well as blood levels of female sex hormones, MSH, SOD and LPO were observed and compared after 3 months of treatment.. In the treatment group, the scores of skin lesion area and color were reduced from 2.76 + or - 0.96 and 2.48 + or - 0.78 before treatment to 1.42 + or - 0.42 and 1.03 + or - 0.41 after treatment, respectively, while in the control group they were from 2.78 + or - 1.06 and 2.53 + or - 0.88 to 1.58 + or - 1.23 and 1.28 + or - 0.96, respectively, all showing significant changes (P<0.05); the scores were insignificantly changed in the blank group (P>0.05). At the same time, the score of symptoms in the treatment group significantly improved after treatment (P<0.05), significantly different from that of the other two groups. Comparison of female sex hormones among groups showed no significant differences either before or after treatment. The level of LPO decreased and SOD increased in both the treatment group and the control group significantly (all P<0.05), but significant lowering of MSH was only seen in the treatment group (P<0.05).. GPRN can effectively lessen the size and lighten the color of chloasma, improve the accompanying symptoms in patients and decrease LPO and MSH levels and increase the SOD level, but will not affect the level of the female sex hormones.

Topics: Acupuncture Points; Acupuncture Therapy; Administration, Topical; Adult; Ascorbic Acid; Biomarkers; Drugs, Chinese Herbal; Female; Gonadal Steroid Hormones; Humans; Melanosis; Needles; Skin Pigmentation; Treatment Outcome; Vitamin E; Western World

Vitamin C has been used for the treatment of hyperpigmented diseases. However, there is no study available on hypopigmenting effect of multivitamin.. To investigate the inhibitory effects of multivitamin and vitamin C on melanogenesis.. We assessed the effect of multivitamin and vitamin C on cell viability, melanogenesis, and mushroom tyrosinase. The antioxidant activity of multivitamin and vitamin C was measured. We performed the Western blot analysis to study the effect of multivitamin and vitamin C on the expression of tyrosinase, microphthalmia-associated transcription factor (MITF), extracellular signal-regulated kinase (ERK), and Akt/protein kinase B. In a clinical trial, 20 melasma patients were treated with split face iontophoresis using either multivitamin or vitamin C. We evaluated the hypopigmenting effects of multivitamin and vitamin C through colorimetric measurement.. Both vitamin C and multivitamin inhibited melanogenesis with low cytotoxicity. Multivitamin reduced melanin contents greater than vitamin C. However, the effects of vitamin C are greater than those of multivitamin on mushroom tyrosinase inhibition and antioxidation. In the Western blot, the reduced tyrosinase expression and MITF level were observed only in multivitamin-treated group, and not in vitamin C-treated group. No changes of ERK and Akt activation were observed in both multivitamin and vitamin C-treated groups. After 12 weeks of treatment with iontophoresis, both multivitamin and vitamin C were effective for melasma.. Multivitamin has shown more anti-melanogenic effect than vitamin C via the downregulation of MITF.

Topics: Animals; Ascorbic Acid; Blotting, Western; Cells, Cultured; Colorimetry; Double-Blind Method; Free Radicals; Humans; In Vitro Techniques; Iontophoresis; Melanins; Melanocytes; Melanosis; Mice; Microphthalmia-Associated Transcription Factor; Monophenol Monooxygenase; Reference Values; Statistics, Nonparametric; Treatment Outcome; Vitamins

Gingival melanin pigmentation may cause esthetic concerns, even if no serious medical problem is present. As an inhibitor of melanin formation, ascorbic acid is often used to treat skin melanin pigmentation. Thus, the present study investigated the effects of ascorbic acid on gingival melanin pigmentation in vitro and in vivo.. The effects of ascorbic acid on melanin formation were evaluated in vitro in B16 mouse melanoma cells and three-dimensional human skin models. In addition, a clinical trial was performed to investigate the inhibitory effects of a gel containing ascorbic acid 2-glucoside (AS-G gel) on gingival melanin pigmentation. This study used a double-masked, split-mouth design on 73 subjects with symmetric gingival melanin pigmentation. AS-G gel was applied to one side of the gingiva for 12 weeks, whereas placebo gel was applied to the other side as a control. Luminance (L*)-value, which describes the lightness of gingiva, was determined by spectrophotometry to obtain an objective measure of melanin pigmentation every 4 weeks.. Ascorbic acid significantly inhibited tyrosinase activity and melanin formation in B16 mouse melanoma cells (P <0.01 and P <0.05, respectively). The inhibitory effects of ascorbic acid on melanin formation were also significant in three-dimensional human skin models (P <0.01). Moreover, in the clinical trial, a significant relative change in pigmentation was seen after 4 weeks with the application of AS-G gel compared to placebo (L*-value ratio).. Ascorbic acid (AS-G) has potential for the treatment of gingival melanin pigmentation.

Topics: Adult; Animals; Antioxidants; Ascorbic Acid; Cell Line, Tumor; Double-Blind Method; Female; Gels; Gingival Diseases; Humans; Male; Melanins; Melanosis; Mice; Monophenol Monooxygenase; Skin Pigmentation; Spectrophotometry

Melasma is a common, acquired, symmetric hypermelanosis characterized by irregular brown to gray-brown macules on the cheeks, forehead, nasal bridge, cutaneous part of the upper lip, mandible, and the upper arms. Few trials have been conducted regarding the potential benefits of oral procyanidin in melasma.. To assess the safety and efficacy of oral procyanidin + vitamins A, C, E among Filipino patients with epidermal melasma.. A randomized, double-blind, placebo-controlled trial lasting 8 weeks, involving 60 adult female volunteers with bilateral epidermal melasma, Fitzpatrick skin types III-V, was conducted at the Section of Dermatology, Research Institute for Tropical Medicine, Department of Health, Manila, Philippines. Patients received either the test drug or placebo, twice daily with meals. Changes in pigmentation were measured using a mexameter, the melasma area and severity index (MASI), and a global evaluation by the patient and investigator. Safety evaluations were performed at each follow-up visit.. Fifty-six patients completed the trial. Mexameter results demonstrated a significant decrease in the degree of pigmentation in the left malar (165.85 +/- 70.909) and right malar (161.33 +/- 61.824) regions (P < 0.0001). MASI scores showed a significant improvement in the left malar (2.4862 +/- 1.67816) and right malar (1.8889 +/- 1.67110) regions (P = 0.001). Procyanidin + vitamins A, C, E proved to be safe and well tolerated, with minimal adverse events.. In this 8-week trial period, oral procyanidin + vitamins A, C, E proved to be safe and effective among Filipino women with epidermal melasma.

Topics: Administration, Oral; Adolescent; Adult; Antioxidants; Ascorbic Acid; Biflavonoids; Catechin; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Melanosis; Middle Aged; Philippines; Placebos; Proanthocyanidins; Treatment Outcome; Vitamin A; Vitamin E; Vitamins; Young Adult

Melasma is a common acquired hypermelanosis that is difficult to treat. Several chemical peeling agents were used in treatment of melasma. Topical vitamin C was also used with minimal side effects.. To compare the effect of 20% trichloroacetic acid (TCA) peel alone vs. 20% TCA peel combined with topical 5% ascorbic acid in cases of epidermal melasma.. Thirty women with bilateral epidermal melasma (Fitzpatrick skin types III and IV) were divided into two groups (A and B, 15 patients each). Before therapy, digital photography and a melasma area and severity index (MASI) score were done for each patient. Groups A and B were primed for 2 weeks before TCA peel. Group B also applied 5% ascorbic acid topically once daily; 20% TCA peel was done for all patients weekly until clearance of melasma or for a maximum of six peels. Group B continued to use 5% ascorbic acid topically in between peels and during the 16-week follow-up period. Patients were assessed at the end of peeling sessions and at the end of follow-up by photography, MASI score, and a global evaluation by the patient.. Group B compared with group A showed a significant decrease in MASI score at the end of TCA peels (P < 0.001) and at the end of the 16-week follow-up period (P < 0.003). Global evaluation showed that 13 patients (87%) in group B improved or maintained their improvement compared with only 10 patients (67%) in group A.. Topical ascorbic acid combined with 20% TCA peel in melasma improves the results and helps in maintaining the response to therapy.

Topics: Administration, Cutaneous; Adult; Ascorbic Acid; Chemexfoliation; Dermatologic Agents; Drug Administration Schedule; Drug Therapy, Combination; Facial Dermatoses; Female; Humans; Melanosis; Middle Aged; Severity of Illness Index; Treatment Outcome; Tretinoin; Trichloroacetic Acid

Melasma is an acquired treatment-resistant hyperpigmentation of the skin.. Sixteen women with idiopathic melasma were included in our trial. After randomization by another clinician, they were instructed to use, at night, 5% ascorbic acid cream on one side of the face and 4% hydroquinone cream on the other side, for 16 weeks. Sunscreen was applied daily throughout the period of observation. They were evaluated every month by colorimetry, digital photography, and regular color slides. Subjective evaluation by each patient was also taken into account.. The best subjective improvement was observed on the hydroquinone side with 93% good and excellent results, compared with 62.5% on the ascorbic acid side (P < 0.05); however, colorimetric measures showed no statistical differences. Side-effects were present in 68.7% (11/16) with hydroquinone vs. 6.2% (1/16) with ascorbic acid.. Although hydroquinone showed a better response, ascorbic acid may play a role in the therapy of melasma as it is almost devoid of side-effects; it could be used alone or in combination therapy.

Topics: Administration, Topical; Adult; Ascorbic Acid; Dermatologic Agents; Double-Blind Method; Female; Humans; Hydroquinones; Melanosis; Treatment Outcome

Vitamin C is known to both inhibit melanin formation and reduce oxidized melanin. However, vitamin C does not easily penetrate the skin. In this study, vitamin C iontophoresis was employed in order to enhance vitamin C penetration.. The purpose of this study was to evaluate the efficacy of vitamin C iontophoresis for melasma patients.. Twenty-nine females with melasma were enrolled. For iontophoresis, a vitamin C solution was applied to one side of the face, while distilled water was applied to the other side as a control. The L (luminance) value was measured by a colorimeter to obtain an objective pigmentation parameter.. Twelve weeks after iontophoresis, the colorimeter of the treated site showed a significant decrease in the L value (from 4.60 to 2.78, p = 0.002), compared to that of the control site (from 4.45 to 3.87, p = 0.142).. Vitamin C iontophoresis may be an effective treatment modality for melasma.

Topics: Adult; Antioxidants; Ascorbic Acid; Computer Graphics; Data Interpretation, Statistical; Double-Blind Method; Female; Humans; Iontophoresis; Melanosis; Middle Aged; Neurocutaneous Syndromes; Research Design; Treatment Outcome

Melasma, also known as mask of pregnancy, is a common, acquired hypermelanosis seen in women with Fitzpatrick skin types II-V, and is often recalcitrant to treatment with depigmentation agents. Glycolic acid has been added to hydroquinone formulations in the past to enhance their depigmentation effects, but may cause irritation, leading to postinflammatory hyperpigmentation.. To assess the safety and efficacy of a cream containing 4% hydroquinone, 10% buffered glycolic acid, vitamins C and E, and sunscreen (Glyquin, ICN Pharmaceuticals, Costa Mesa, USA) vs. a cream containing sunscreen alone in the depigmentation of epidermal melasma of the face.. Thirty-nine Hispanic women, Fitzpatrick skin types III-V, with bilateral epidermal melasma were enrolled in a randomized controlled trial lasting 12 weeks. Patients underwent twice-daily full-face application with the study cream or with the cream containing sunscreen only. Changes in pigmentation were measured using a mexameter, the melasma area and severity index (MASI), and a global evaluation by the patient and blind investigator. Safety evaluations were performed at each follow-up visit.. Thirty-five patients completed the trial. Irritation was more common with the study cream, but resolved with temporary cessation of cream application and the addition of moisturizers. Mexameter results demonstrated a significant decrease in the degree of pigmentation using the study cream compared with the cream containing sunscreen alone (P < 0.0001). Fifteen of 20 patients (75%) using the study cream improved, whereas only two of 15 patients (13%) improved using sunscreen alone.. A cream containing 4% hydroquinone, 10% buffered glycolic acid, vitamins C and E, and sunscreen is safe and effective in the treatment of melasma.

Topics: Administration, Cutaneous; Adult; Ascorbic Acid; Drug Therapy, Combination; Female; Glycolates; Humans; Hydroquinones; Keratolytic Agents; Melanosis; Severity of Illness Index; Sunscreening Agents; Treatment Outcome; Vitamin E

A multi-clinical double-blind study on therapeutic effect of combination preparation of vitamins E and C was undertaken in comparison with single preparation of vitamin E and vitamin C in the treatment of chloasma or pigmented contact dermatitis (PCD). Combination treatment resulted in significantly better clinical improvement than vitamin C alone in both diseases. Objective data compiled from color difference measurements and color photographs revealed significantly better results with combination treatment in chloasma than vitamin C alone and, in PCD, than vitamin E or C alone. Differences in skin luminosity between hyperpigmented and normal areas significantly decreased in all three groups, with the combination group producing the most significant change. The total serum lipoperoxide level and its ratio to total serum lipids tended to decline in the combination group, and decreased significantly in vitamin E group. The sebum lipoperoxide level decreased significantly only in the combination group (EC).

Topics: alpha-Tocopherol; Ascorbic Acid; Clinical Trials as Topic; Dermatitis, Contact; Double-Blind Method; Drug Therapy, Combination; Humans; Lipid Metabolism; Lipid Peroxides; Melanosis; Photography; Sebum; Skin Pigmentation; Tocopherols; Vitamin E

Melasma is a common esthetic problem affecting the face with a lot of risk factors being incriminated. Although several treatment options are available, none of them is satisfactory. This split face prospective study aimed to compare the efficacy of microneedling with vitamin C versus with platelet-rich plasma (PRP) in the management of mixed melasma. Ten females with bilateral mixed facial melasma were treated with six sessions of microneedling. After the needling vitamin C was applied on the right side of the face and PRP was applied on the left side. Clinical, dermoscopic, and histological assessment of the used treatments was done 1 month after the last session. The clinical and dermoscopic clearance of melasma was proved significantly on both sides of the face but was more significant with vitamin C (P = 0.005). Reduction of epidermal melanin and dermal melanophages was more observed with vitamin C. Moreover, MART-1 stain revealed a more significant reduction in the epidermal, dermal, and the total MART-1 positive cells with vitamin C (P = 0.044, 0.039, and 0.035, respectively). Microneedling with vitamin C was more efficient in treating mixed melasma than with PRP.

Topics: Ascorbic Acid; Combined Modality Therapy; Female; Humans; Melanosis; Platelet-Rich Plasma; Prospective Studies; Treatment Outcome

Melasma is a complex pigmentary disorder with challenging management.. Evaluation of efficacy of topical tranexamic acid (TXA) versus Vitamin C (Vit C) with microneedling (MN) in melasma therapy.. In 30 females with melasma, after 4 weeks of using Modified Kligman's formula, the right side of the face was treated with MN + TXA and the left with MN + Vit C for five biweekly sessions. Wood's light, dermoscopy, Melasma Area and Severity Index (MASI), MASI malar right and malar left (MASI. Both MASI. MN followed by Vit C or TXA is successful in melasma management, the latter being advantageous vis-a-vis dermal vascularity and epidermal pigmentation. Dermoscopic evaluation appears crucial in choosing optimum treatment in each patient.

Topics: Ascorbic Acid; Dermatologic Surgical Procedures; Female; Humans; Melanosis; Needles; Single-Blind Method; Tranexamic Acid; Treatment Outcome

Melasma is a common hyperpigmentation disorder with numerous, but often unsatisfactory treatment options.. A pilot study to evaluate the efficacy and safety of a novel topical combination of 12% hydroquinone, 6% kojic acid, and 5% vitamin C cream for melasma.. A pilot study of 6 women with melasma was conducted at an academic dermatology department and a private dermatology practice to evaluate the efficacy of a topical combination of 12% hydroquinone, 6% kojic acid, and 5% vitamin C cream, entitled the "Tam Formula." Two blinded evaluators calculated Melasma Area and Severity Index (MASI) Scores before and after treatment to evaluate change from baseline, and statistical analysis was performed.. Treatment with this combination topical cream resulted in an average 63.77 ± 22.10 percent reduction in MASI scores.. While there is a need for further investigation, this pilot study indicates the Tam Formula may provide an alternative treatment option for melasma.

Topics: Ascorbic Acid; Female; Humans; Hydroquinones; Melanosis; Pilot Projects; Skin Cream; Treatment Outcome

Riehl's melanosis is a chronic, refractory disorder, which can adversely affect patient's quality of life. Intense pulse light, neodymium-doped yttrium aluminum garnet laser, hydroquinone, tranexamic acid have been reported to treat this disease, but there have been few reports on the effectiveness of other treatments.. To assess the efficacy and safety of triple combination therapy with salicylic acid chemical peels, oral glycyrrhizin compound, and vitamin C for Riehl's melanosis.. Three patients diagnosed with Riehl's melanosis were enrolled. All patients were treated with glycyrrhizin compound (150 mg/d), vitamin C (100 mg/d), and salicylic acid 30% peels once every 2 weeks. Clinical photographs and VISIA were used to assess the efficacy.. All patients received obvious improvement and reported no obvious side effects.. Triple combination therapy with salicylic acid peels, oral glycyrrhizin compound, and vitamin C is a safe and effective modality for Riehl's melanosis.

Topics: Administration, Cutaneous; Administration, Oral; Adult; Ascorbic Acid; Chemexfoliation; Combined Modality Therapy; Drug Therapy, Combination; Female; Glycyrrhizic Acid; Humans; Male; Melanosis; Middle Aged; Salicylic Acid; Treatment Outcome

Vitamin C (L-Ascorbic acid) has many favourable effects on the skin such as antioxidant, anti-aging and whitening effects. Its instability and low permeability limit its pharmaceutical use in cosmetic and dermatological products. Instead, Mg ascorbyl phosphate (MAP), an ascorbic acid derivative, has the same effect with higher stability is being used. In this work, a vesicular system, aspasomes, containing MAP was developed and evaluated. Aspasomes are multilayered vesicles formed by amphiphiles molecules, Ascorbyl palmitate (ASP), in combination with cholesterol and charged lipids for drug encapsulation. Here, we investigated the use of lecithin instead of the charged lipid dicetyl phosphate for aspasomes development. Nine formulations were prepared and evaluated for their entrapment efficiency, particle size, polydispersity index (PDI) and zeta potential. Their entrapment efficiency ranged from 33.00 ± 2.27 to 95.18 ± 1.06, while their particle size was from 373.34 ± 60.85 to 464.37 ± 93.46 nm with acceptable PDI (from 0.212 ± 0.068 to 0.351 ± 0.061) and zeta potential (from -37.52 ± 2.42 to -50.36 ± 1.82). Three formulations were selected and evaluated for their drug release, permeation and retention into skin. One formulation was selected to be formulated as aspasomal topical cream and gel. The aspasomal cream was found to have enhanced drug permeation and skin retention over the aspasomal gel as well as the aspasomes formulation. MAP aspasomal cream was evaluated clinically as an effective treatment for melasma against 15% trichloroacetic acid (TCA) and the results recorded that the aspasomal cream showed the greatest degree of improvement regarding the hemi-MASI scores with 35% of patients rating it as excellent treatment. The study showed that MAP aspasomal cream can be considered a novel treatment of melasma which is free of side effects. Its efficacy as a monotherapy is superior to that of chemical peeling using 15% TCA.

Topics: Administration, Cutaneous; Animals; Antineoplastic Agents; Ascorbic Acid; Biological Transport; Cholesterol; Drug Compounding; Drug Liberation; Drug Stability; Humans; Lecithins; Liposomes; Magnesium; Male; Melanosis; Rats, Wistar; Skin; Skin Absorption; Treatment Outcome

Treatment of melasma and postinflammatory hyperpigmentation is often challenging. No ideal short-term and long-term treatment is available. Vitamin C alone and in combination with iontophoresis has been studied and found to be useful; however, no long-term studies have been published.. In this study, 35 patients (34 female, 1 male) were treated with a novel full-face iontophoresis mask (FFIM) and a proprietary vitamin C (ascorbyl glucoside) preparation. Patients received one in-office treatment and 12 to 24 at-home treatments over 1 to 2 months in conjunction with a strict maintenance regimen consisting of a mandelic/malic acid skin care regimen, broad-spectrum ultraviolet A/ultraviolet B sunblock, a wide-brimmed hat, and sun-avoidance behavior. Follow-up after the initial in-office treatment ranged from 1 to 54 months (mean, 26 months). Four independent observers graded improvement of melasma and PIH using a 4-point scale. Before the study, high-performance liquid chromatography was used to verify iontophoretic penetration of vitamin C into the skin to a level of 0.2 cm in healthy volunteers (2 male, 2 female).. A mean 73% improvement in abnormal pigmentation was observed at the end of FFIM/vitamin C treatment. Greater than 25% improvement was observed in 32 of 35 patients, and greater than 50% improvement in 22 of 35 patients. Melasma Area and Severity Index scores demonstrated substantial improvement from baseline for all patients, with a mean improvement of 15.7.. Full-face iontophoresis of vitamin C appears to be an effective short-term treatment for melasma and postinflammatory hyperpigmentation. A protocol of strict sun avoidance in combination with a mandelic/malic acid skin care regimen appears to be useful in maintaining the improvement.

Topics: Adult; Ascorbic Acid; Chromatography, High Pressure Liquid; Female; Follow-Up Studies; Humans; Hyperpigmentation; Iontophoresis; Malates; Male; Mandelic Acids; Masks; Melanosis; Middle Aged; Skin; Skin Absorption; Sunscreening Agents; Treatment Outcome; Vitamins

Melasma is difficult to treat. Vitamin C, topical and by iontophoresis, has been shown to be useful. When lasers are used, there is a significant incidence of post-laser hyperpigmentation. There is no single established treatment for the latter. The case history of a 51-year-old Chinese woman is presented. Intravenous vitamin C appears to be useful in treating this complication.

Topics: Ascorbic Acid; Female; Humans; Hyperpigmentation; Injections, Intravenous; Iontophoresis; Low-Level Light Therapy; Melanosis; Middle Aged

Objective methods of measuring skin color are needed to evaluate pigmentary lesions quantitatively. We have developed a new method of measuring skin color using a plastic bar system called the Skin Tone Color Scale based on Munsell's color space system. We have also evaluated the effectiveness of various therapies using this measurement system. Our system was designed to measure skin color in normal skin, pigmentary lesions of solar lentigo, chloasma and ephelides, and postinflammatory pigmentation. Moreover, effectiveness of various therapies for these pigmentary lesions was evaluated. The evaluations made with this system were closely related to physician assessment. This method may be useful in measuring of skin color and evaluating the effectiveness of therapies for pigmentary diseases.

Topics: Adolescent; Adult; Aged; Ascorbic Acid; Dermatologic Agents; Dermatology; Face; Female; Humans; Hyperpigmentation; Laser Therapy; Lentigo; Melanosis; Middle Aged; Phototherapy; Skin Pigmentation; Statistics, Nonparametric; Tranexamic Acid

An inhibitory effect of ascorbic acid (AsA) on melanogenesis has been described. However, AsA is quickly oxidized and decomposed in aqueous solution and thus is not generally useful as a depigmenting agent.. Our purpose was to examine the effect on pigmentation of magnesium-L-ascorbyl-2-phosphate (VC-PMG), a stable derivative of AsA.. Percutaneous absorption of VC-PMG was examined in dermatomed human skin, and its effect on melanin production by mammalian tyrosinase and human melanoma cells in culture was also measured. A 10% VC-PMG cream was applied to the patients.. VC-PMG suppressed melanin formation by tyrosinase and melanoma cells. In situ experiments demonstrated that VC-PMG cream was absorbed into the epidermis and that 1.6% remained 48 hours after application. The lightening effect was significant in 19 of 34 patients with chloasma or senile freckles and in 3 of 25 patients with normal skin.. VC-PMG is effective in reducing skin hyperpigmentation in some patients.

Topics: Ascorbic Acid; Female; Humans; In Vitro Techniques; Melanins; Melanoma, Experimental; Melanosis; Monophenol Monooxygenase; Skin Absorption; Skin Neoplasms; Tumor Cells, Cultured

Topics: Ascorbic Acid; Dentistry; Melanosis; Tongue

Topics: Acne Vulgaris; Adolescent; Amino Acids; Ascorbic Acid; Dermatitis; Dermatitis, Contact; Dermatology; Drug Eruptions; Eczema; Erythema; Glutamates; Melanosis; Neurodermatitis; Pantothenic Acid; Polyarteritis Nodosa; Psoriasis; Tablets; Tiopronin; Toxicology; Urticaria

Topics: Ascorbic Acid; Colonic Diseases; Humans; Melanosis; Vitamins

Topics: Ascorbic Acid; Humans; Melanosis; Pigmentation; Vitamins