Técnica de microagulhamento associado ao ácido tranexâmico no tratamento de melasmas: uma revisão / Micro-needling technique associated with tranexamic acid in the treatment of melasmas: a review

Júlia Regina Schuch, Simone Rossetto

Abstract


Melasma é uma hipermelanose comum, crônica e de difícil tratamento, que afeta face e membros superiores, influenciando na qualidade de vida e aceitação da auto-imagem especialmente em mulheres. É um desafio dermatológico, com diversas propostas para o controle de hiperpigmentação, sendo o ácido tranexâmico uma opção segura de tratamento com diferentes formas de uso e técnicas associadas. Objetivo: Revisar os dados publicados acerca da aplicação de ácido tranexâmico tópico e associado a técnicas de administração intradérmica no controle de melasmas. Método: Revisão bibliográfica em livros e artigos pesquisados nas bases de dados Pubmed, Scielo, Capes, Google Acadêmico e Science Direct, publicados entre 2009 e 2019. Resultados: Foram incluídos 19 estudos, sendo 4 revisões bibliográficas e 15 ensaios clínicos. O uso do ácido tranexâmico foi avaliado entre as diferentes vias de administração, com variação na concentração utilizada, com resultados satisfatórios tanto com uso tópico quanto intradérmico. Conclusão: O ácido tranexâmico tem se apresentado como potencial opção terapêutica segura e eficaz no controle de melasma, tanto através de aplicação tópica quanto intradérmica, sendo necessários mais estudos para maiores esclarecimentos.


Keywords


Melasma, microagulhamento, ácido tranexâmico.

References


GOMES, R. K.; DAMAZIO, M. G. Cosmetologia: descomplicando os princípios ativos. 4 ed. São Paulo, SP: LMP Editora, 2013.

SOUTOR, C.; HORDINSKY, M. Dermatologia clínica. 1 ed. São Paulo, SP: Mc Graw Hill, 2014.

KAMIZATO, K. K.; BRITO, S. G. Técnicas estéticas faciais. 1 ed. São Paulo, SP: Editora Saraiva, 2014.

MIOT L. D. et al. Physiopathology of melasma. Anais Brasileiros de Dermatologia, Rio de Janeiro, v. 84, p. 623–35, 2009.

ALAM, M. et al. Dermatologia cosmética. 1ed. Rio de Janeiro: Elsevier, 2010.

JAGANNATHAN, M. et al. Clinico-epidemiological Study of Patients with Melasma in a Tertiary Care Hospital - A Prospective Study. International Journal of Scientific Study, Índia, v. 4, p. 11, feb. 2017.

STEINER, D. et al. Treatment of Melasma: systematic review. Surgical & Cosmetic Dermatology, Rio de Janeiro, v: 1, p. 87-94, 2009.

HANDEL A. C. et al. Melasma: a clinical and epidemiological review. Anais Brasileiros de Dermatologia, Rio de Janeiro, v. 89, p. 771–782, 2014.

NICOLAIDOU, E.; KATSAMBAS, A.D. Pigmentation disorders: hyperpigmentation and hypopigmentation. Clinics in Dermatology, v.32, p. 66-

, 2014.

FILONI, A. et al. Melasma: How hormones can modulate skin pigmentation. Journal of Cosmetic Dermatology, EUA, v. 18, n. 2, p. 1-6, 2019.

FEDELES F.; ROBINSON, B. L. Pigmentary disorders of the skin. Lever’s

Histopathology of the Skin, Philadelphia, PA, 11th ed., 2015.

TAMLER, C. et al. Classification of melasma by dermoscopy: comparative study with Wood’s lamp. Surgical & Cosmetic Dermatology, Rio de Janeiro, v. 1, n. 3, p. 115-119, 2009.

DEABRATA, B. Topical treatment of melasma. Indian Journal Dermatology, West Bengal, India, v. 54, n. 4, p. 303-309, out-dec. 2009.

AZULAY, M. M. et al. Objective methods for analyzing outcomes in research studies on cosmetic dermatology. Anais Brasileiros de Dermatologia, Rio de Janeiro, v. 85, n.1, p 65-71, 2010.

CESTARI, T. F. et al. Melasma in Latin America: options for therapy and treatment algorithm. Journal of the European Academy of Dermatology and Venereology, Alemanha, v. 23, n. 7, p. 760-72, jul. 2009.

PANDYA, A. et al. Reliability assessment and validation of the Melasma Area and Severity Index (MASI) and a new modified MASI scoring method. Journal of the American Academy of Dermatology, Alemanha, v. 64, n. 1, p. 78-83, jan. 2011.

LEE A. Y. Recent progress in melasma pathogenesis. Pigment Cell and Melanoma Research, v. 28, n.6, p. 648–60, 2015.

BALA, H. et al. Oral Tranexamic Acid for the Treatment of Melasma: A Review. Dermatology Surgery. Illinois, USA, v.0, p. 1–12, 2018.

TAMEGA A. de A. et al. Clinical patterns and epidemiological characteristics of facial melasma in Brazilian women. Journal of European Academy of Dermatology and Venereology, Alemanha, v. 27, p. 151–6, 2013.

ARELLANO I. et al. Melasma in Latin America: options for therapy and treatment. Journal of the European Academy of Dermatology and Venereology, Alemanha, v. 23, n. 7, p. 760-772, jul. 2009.

SAKI, N. et al. Comparing the efficacy of topical hydroquinone 2% versus intradermal tranexamic acid microinjections in treating melasma: a split-face controlled trial. Journal of Dermatological Treatment. Irã, v. 29, n. 4, p. 405–410, 2017.

MAEDA K. T. Y. Mechanism of the inhibitory effect of tranexamic acid on melanogenesis in cultured human melanocytes in the presence of keratinocyte-conditioned medium. Journal of Health Sciences, Sarajevo, Bosnia and Herzegovina, v.53, p. 389–96, 2015.

KIM M. S. et al. Efficacy and possible mechanisms of topical tranexamic acid in

Melasma. Clinical and Experimental Dermatology, v. 41, p. 480–485, 2016.

XU Y. et al. Efficacy of functional microarray of microneedles combined with topical tranexamic acid for melasma. Medicine, Baltimore, EUA, v. 96, n. 19, may. 2017.

KIM, H. J. et al. Efficacy and Safety of Tranexamic Acid in Melasma: A Meta-analysis and Systematic Review. Acta Dermato Venereologica, Uppsala, Sweden, v. 97, p. 776-781, apr. 2017.

ZHANG, L. et al. Tranexamic acid for adults with melasma: a systematic review and meta-analysis. BioMed Research International, EUA, v. 2018, 2018.

BUDAMAKUNTLA L. et al. A Randomised, Open-label, Comparative Study of Tranexamic Acid Microinjections and Tranexamic Acid with Microneedling in Patients with Melasma. Journal of Cutaneous and Aesthetic Surgery, India, v. 6, n. 3, p 139-43, jul 2013.

SETTERFIELD I. The concise guide to dermal needling (medical edition). Virtual Beauty Corporation LTDA. USA, V. 1, 2013.

CASTAÑEDA, P. S. et al. Microneedles as enhancer of drug absorption through the skin and applications in medicine and cosmetology. Journal of Pharmacy & Pharmaceutical Sciences, Canadá, v. 21, p.73-93, 2018.

KHURANA, V. K. et al. A randomized, open-label, comparative study of oral tranexamic acid and tranexamic acid microinjections in patients with melasma. Indian Journal of Dermatology, Venereology and Leprology, India, v.85, n. 1, p. 39-43, 2019.

NOGUEIRA, M. N., FERREIRA, L. A. Efficacy of topical tranexamic acid in the treatment of melasma: clinical evidence. Revista de Ciências Médicas e Biológicas, Salvador, v. 17, n. 2, p. 236-241, 2018.

PERPER, M. et al. Tranexamic acid in the treatment of melasma: a review of the literature. American Journal of Clinical Dermatology, Suíça, v. 18, n. 6, 2017.

LIMA, E. A. Microagulhamento em melasma facial recalcitrante: uma série de 22 casos. Anais Brasileiros de Dermatologia, Rio de Janeiro, v. 90, n. 6, p 917-919, 2015.

LIMA, E. A., et al. Microagulhamento: estudo experimental e classificação da injúria provocada. Surgical and Cosmetic Dermatology, Rio de Janeiro, v. 5, n. 2, 2013.

VIDEIRA, I. F. S. et al. Mechanisms regulating melanogenesis. Anais Brasileiros de Dermatologia, Rio de Janeiro, v. 88, n. 1, p. 76-83, 2013.

NISHIMURA E. K. et al. Key Roles for Transforming Growth Factor β in Melanocyte Stem Cell Maintenance. Cell Press, USA, v. 6, n. 2, p. 130-140, 2010.

KANECHORN, P. et al. Topical 5% tranexamic acid for the treatment of melasma in Asians: A double-blind randomized controlled clinical trial. Journal of Cosmetic and Laser Therapy, v. 14, p. 150–154, 2012.

CHUNG, J.Y. et al. Topical tranexamic acid as an adjuvant treatment in melasma: Side-by-side comparison clinical study. Journal of Dermatological Treatment, v. 27, n. 4, p. 373-377, 2016.

EBRAHIMI B.; NAEINI F. F. Topical tranexamic acid as a promising treatment for melasma. Journal of Research in Medical Sciences, Isfahan, v. 19, p. 753–7, 2014.

BANIHASHEMI, M. et al. Comparison of therapeutic effects of liposomal Tranexamic Acid and conventional Hydroquinone on melasma. Journal of Cosmetic Dermatology, v. 14, n. 3, p. 174-177, 2015.

JANNEY, M. S. et al. A randomized controlled study comparing the efficacy of topical 5% tranexamic acid solution versus 3% hydroquinone cream in melasma. Journal of Cutaneous and Aesthetic Surgery, Índia, v. 12, n. 1, p.63-67, 2019.

POOJARY S.; MINNI K. Tranexamic acid in melasma. Journal of Pigmentary Disorders, Mumbai, India, v.2. p. 288, 2015.

PAZYAR, et al. Comparison of the efficacy of intradermal injected tranexamic acid vs. hydroquinone cream in the treatment of melasma. Clinical, Cosmetic and Investigational Dermatology, Iran, v.12, p.115-122, 2019.

SARAIVA, L. P. P. G. Tratamento de melasma facial com associação do microagulhamento robótico e drug delivery de ácido tranexâmico. Surgical and Cosmetic Dermatology. Rio de Janeiro, v.10, n.4, p. 333-339, 2018.

KALLURI H. et al. Characterization of Microchannels Created by Metal Microneedles: Formation and Closure. AAPS Journal, USA, v.13, n.3, p. 473-481, 2011.

PRAGYA A. et al. Microneedling Using Dermaroller A Means Of Collagen Induction Therapy. Gujarat Medical Journal, India, v. 69, n. 1, 2014.

NEGRÃO, M. M. C. Microagulhamento: bases fisiológicas e práticas. 1 ed. São Paulo: CR8 Editora, 2015.

SHARMA, R. et al. Therapeutic efficacy and safety of oral tranexamic acid and that of tranexamic acid local infiltration with microinjections in patients with melasma: a comparative study. Clinical and Experimental Dermatology. Índia, V. 42, p. 728–734, 2017.

SHETTY, V., SHETTY, M. Comparative study of localized intradermal microinjection of tranexamic acid and oral tranexamic acid for the treatment of melasma. International Journal of Research in Dermatology, India, V. 4, n. 3, p. 363-367, 2018.




DOI: https://doi.org/10.34117/bjdv7n1-480

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