Combination of 5% Cysteamine Serum and 3% Tranexamic Acid Cream using Layering Technique for Treatment of Melasma: A Pilot Study
Keywords:
Cysteamine Serum, Tranexamic Acid, Layering technique, MelasmaAbstract
Introduction: Melasma is a hyperpigmentation disorder characterized with brown to gray-black macules and patches with irregular edges on the facial area. The exact pathogenesis of the disease is complex and has yet to be fully understood. Although the condition is benign, it can significantly affect patient’s cosmetical appearance and subsequent self-esteem, leading to significant impairment of patient’s quality of life (QoL). Objective: To assess the effectiveness of 5% cysteamine serum combined with 3% tranexamic acid cream using layering technique for treatment of melasma. Materials and Method: The study design is a pretest-posttest clinical trial conducted at the dermatology outpatient clinic of Hasanuddin University Hospital and Wahidin Sudirohusodo Hospital, Makassar, South Sulawesi, Indonesia from December 2020-December 2021. A total of 40 subjects that met the inclusion criteria participated in the study. Subjects were instructed to cleanse their face at night and apply two drops of 5% cysteamine serum over the face for 15 minutes, followed with application of 1 fingertip unit (FTU) of 3% tranexamic acid cream. Parameters for assessment used in this study are modified melasma severity index (mMASI) score, pigmented facial spots using Janus Skin AnalyzerÒ, L* value using ChromameterÒ and Melanin Index (MI) using MexameterÒ. Results: There were significant improvements in all parameters with a mean mMASI score decrease of 0.42 point from 7.97 to 7.55 (p <0.05), decreased pigmented facial spots from 52.29 to 49.17 (p<0.05), an increase of L* value from 46.82 to 50.88 from W0 to W8 using Chromameter® (p<0.05), and a 48.94-point decrease in MI using Mexameter ® from 359.49 to 310.55 (p<0.05). Conclusion: Combination of 5% cysteamine serum and 3% tranexamic acid cream using layering technique is a promising combined regiment for treatment of melasma.References
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