I-Tranexamic Acid Mesotherapy yeMelasma: iProtocol, iziphumo kunye noKhuseleko

I-Melasma yenye yeengxaki ze-pigment eziphoxayo kwiikliniki. Ibuya emva kwelaser, ivutha lilanga kunye neehomoni, kwaye ihlala isilela ukuphendula kwihydroquinone yodwa. Yiyo loo nto inaliti ye-tranexamic acid yokuqaqambisa ulusu kunye nolawulo lwe-melasma iye yasuka kubuchule be-niche yaya kwisicelo esiqhelekileyo kwiinkqubo zobuhle kulo lonke elase-Asiya, kuMbindi Mpuma naseYurophu. Esi sikhokelo sibandakanya indlela i-tranexamic acid (TXA) esebenza ngayo kwi-pigment, into eboniswa yidatha yeklinikhi epapashiweyo ngokwenene, ukuba oogqirha badla ngokuyiqhuba njani iprothokholi ye-TXA mesotherapy, kwaye zeziphi na abasasazi kunye neempawu zekliniki ekufuneka bezijongile phambi kokufumana ifomula ye-TXA.

Yintoni i-Tranexamic Acid kwaye Kutheni isetyenziswa eLusuni?

I-Tranexamic acid iphuma kwi-amino acid lysine. Yaqala yaphuhliswa njengechiza le-antifibrinolytic, oku kuthetha ukuba kunciphisa ukopha ngokuthintela ukuguqulwa kwe-plasminogen kwi-plasmin. I-dermatologists yaba nomdla kuyo emva kokuba abaphandi baqaphele ukuba ukuvala indlela ye-plasminogen-plasmin ikwanciphisa i-pigmentation eyenziwe yi-ultraviolet.

Kwiyeza lobuhle, i-TXA ngoku isetyenziswa kwiindlela ezintathu eziphambili:

• Iiserum zezihloko kunye neekhrimu, ngokuqhelekileyo kwiindawo eziphantsi

• Iipilisi zomlomo , ezichazwe ngoogqirha kwi-melasma enganyangekiyo

• Intradermal microinjection (mesotherapy) , apho isisombululo se-dilute sibekwe ngqo kwindawo enemibala

Eli nqaku ligxininisa kwindlela yesithathu, ehlala ikhangelwa njenge 'tranexamic acid mesotherapy' okanye 'tranexamic acid ampoule for skin'. Ukuze ufumane amagqabantshintshi abanzi okhetho lokuqaqambisa olutofwayo, bona isikhokelo sethu indlela izitofu eziqaqambisa ulusu zinceda ngayo ukunyanga i-hyperpigmentation.

I-Tranexamic Acid Yehlisa Njani Ukuba Nebala Lebala

I-Melasma ayikho nje 'i-melanin eninzi'. Ibandakanya incoko phakathi kweentlobo ezininzi zeeseli eluswini. Nalu uguqulelo olwenziwe lula lwendlela i-TXA eyiphazamisa ngayo.

Ukuthintela umqondiso weplasmin

Xa ulusu lubonakaliswe ekukhanyeni kwe-UV, i-keratinocytes ivelisa i-activator ye-plasminogen eninzi. I-Plasmin emva koko ikhupha iimolekyuli ezibonisa iimpawu ezifana ne-arachidonic acid kunye ne-prostaglandins, ezityhala i-melanocytes ukuvelisa i-melanin engakumbi. I-TXA ivala ukusebenza kwe-plasminogen, ukuze isignali evuselelayo ibe buthathaka kumthombo wayo.

Ukujolisa icandelo le-vascular

Izilonda ze-Melasma zihlala zibonisa imithambo yegazi encinci ngakumbi kunesikhumba esijikelezileyo, kwaye izinto zokukhula kwemithambo zibonakala zondla umjikelo we-pigment. Ngenxa yokuba i-TXA ikwasebenza kwindlela ye-plasmin ebandakanyekayo kwi-angiogenesis, inokunceda kubomvu-bumdaka, inkangeleko yemithambo yezinye iindawo ze-melasma. Esi sesinye isizathu sokuba i-TXA iziphathe ngokwahlukileyo kwi-tyrosinase inhibitors ecocekileyo.

Kutheni oku kubalulekile kukhetho lonyango

Izithako ezifana ne-glutathione, ivithamin C, i-kojic acid kunye ne-arbutin ikakhulu zisebenza kwi-melanin synthesis ngokwayo. I-TXA isebenza phezulu, kwiimpawu eziyibangelayo. Loo nto iyenza iqabane elisengqiqweni endaweni endaweni. Ukuba ufuna iinkcukacha kwicala le-antioxidant, inqaku lethu Isitofu seglutathione kunye nesikhumba esimhlophe sichaza indlela iglutathione eyiphembelela ngayo ibala. Ukuphumla kwesi sikhokelo kuhlala ne-TXA kunye ne-melasma.

Yintoni eboniswa bubungqina bezonyango

I-TXA microinjection ifundwe kwizilingo eziphononongwe ngontanga, nangona uninzi luncinci kwaye luvulekile. Izifundo ezibini ezisoloko zicatshulwa zinika umfanekiso oyinyaniso:

• U-Lee et al., i-Dermatologic Surgery (2006). Kuphononongo oluvulekileyo lweeveki ze-12 ze-100 zabasetyhini baseKorea abane-melasma, i-0.05 mL ye-TXA (4 mg / mL) ifakwe i-intradermally kwi-1 cm ngamaxesha kanye ngeveki. Abaguli abangamashumi asibhozo anesihlanu balugqibile uphononongo. I-Melasma Area ye-Melasma kunye ne-Severity Index (MASI) yawa ukusuka kwi-13.22 kwisiseko ukuya kwi-7.57 ngeveki ye-12, kwaye imiphumo emibi yachazwa njengento encinci.

• Budamakuntla et al., Ijenali yeCutaneous and Aesthetic Surgery (2013). Izigulana ezingamashumi amathandathu zaye zasiwa kwi-TXA microinjections okanye i-TXA yaziswa nge-microneedling, kunye neeseshoni ezintathu zenyanga. I-MASI iphuculwe nge-35.72% kwiqela le-microinjection kunye ne-44.41% kwiqela le-microneedling, kungekho ziganeko ezimbi ezibikiweyo.

Zicebisa ntoni ezi zifundo:

1. I-TXA mesotherapy inokuvelisa ukunciphisa okunentsingiselo kubunzima be-melasma kwiiveki ze-8-12.

2. Iziphumo ziyahluka. Kuphononongo luka-Lee, izigulane ezininzi zilinganise ukuphucuka kwazo njenge 'fair' (26-50% lightening) endaweni yokukhutshwa ngokupheleleyo.

3. Imiba yendlela yokuhanjiswa, kunye nokudibanisa ne-microneedling kunokuphucula ukungena.

Akukho naluphononongo lungqina ukuvunywa ngokusisigxina. I-Melasma sisifo esingapheliyo, ngoko ke iiklinikhi kufuneka zibonise i-TXA njengesixhobo sokulawula nokugcina, kungekhona unyango.

IProtokholi ye-TXA ye-Mesotherapy

Iiprothokholi ziyahluka phakathi kwabasebenzi kunye neemveliso, kwaye nasiphi na isicwangciso sonyango kufuneka silandele imiyalelo yemveliso yokusetyenziswa kunye nemimiselo yezonyango yendawo. Ulwakhiwo jikelele olusetyenziswa kwiikliniki lukhangeleka ngolu hlobo.

Ukukhetha isigulane kunye nokulungiselela

• Qinisekisa ukuxilongwa. I-Melasma, i-post-inflammatory hyperpigmentation kunye ne-solar lentigines ziphendula ngokuhlukileyo.

• Isikrini se-contraindications. I-TXA ichaphazela i-clotting pathways, ngoko ke imbali ye-thromboembolism, ukuphazamiseka kwe-clotting, unyango lwe-anticoagulant okanye ukukhulelwa kufuna ukuba kuhlolwe ugqirha ngaphambi kokuba unyango.

• Fota ummandla phantsi kokukhanya okuhambelanayo, kwaye uphawule nge-MASI okanye umlinganiselo ofanayo wokulandelela injongo.

• Coca ulusu kwaye usebenzise i-anesthetic yangaphandle ukuba kuyimfuneko.

Indlela yokutofa

• Ubunzulu: ukubekwa kwe-intradermal engaphezulu, malunga ne-0.5-1 mm.

• Isithuba kunye nomthamo: ii-aliquots ezincinci zisasazeka ngokulinganayo kwi-lesion. Iiprothokholi ezipapashiweyo ezisetyenziswe malunga ne-0.05 mL kwinqanaba ngalinye kwii-1 cm.

• Izixhobo zokuhambisa: isirinji ye-insulin, i-meso gun, okanye i-microneedling pen kunye ne-roller, kuxhomekeke kuyilo lwemveliso kunye nokukhethwa kwekliniki.

Ubuninzi beseshoni

Izifundo ezipapashiweyo ezisetyenziselwa iiseshoni zeveki (Lee 2006) okanye iiseshoni zenyanga (Budamakuntla 2013). Uninzi lwezisombululo ze-mesotherapy ze-TXA zicebisa iseshoni enye rhoqo kwiiveki ezimbini. Ikhosi idla ngokuqhuba iiseshini ze-4-8, zilandelwa lunyango lolondolozo njengoko lufuneka.

Ukhathalelo lwasemva

• Ukhuseleko olungqongqo kwilanga elibanzi yonke imihla. Ngaphandle kwayo, naluphi na uphuculo luya kuphelelwa.

• Gwema ukushisa, i-saunas kunye nokusebenza okunamandla kwiiyure ezingama-24-48.

• Lindela ububomvu obuphakathi, ukugruzuka okucacileyo okanye amaqhuma amancinci adla ngokuhlala kwisithuba sosuku okanye ezimbini.

Ukudibanisa i-TXA kunye neminye imisebenzi eqaqambileyo

Indlela ye-TXA's upstream idibana kakuhle kunye nezithako ezisebenza ngakumbi kwi-melanin pathway. Imixube yangoku ihlala idibanisa i-TXA kunye:

• I-Glutathione kunye ne-vitamin C yenkxaso ye-antioxidant kunye ne-tyrosinase inhibition

• I-asidi ye-Kojic, i-arbutin okanye i-glycolic acid ukuxhasa ithoni kunye nokuguqulwa kweseli

• I-PDRN (i-polydeoxyribonucleotide) ukuxhasa ukulungiswa kwesikhumba kunye nokubuyisela umqobo, obalulekileyo kwi-melasma yesikhumba esibuthathaka okanye esonakaliswe nge-laser.

I-AOMA's I-Tranexamic Acid Skin Whitening Injection kunye ne-PDRN ilandela le ndlela yokwenza izinto ezininzi. Idibanisa i-PDRN, i-tranexamic acid, i-glutathione, i-glycolic acid, i-kojic acid kunye ne-vitamin C kwii-vials ze-5 mL zokusetyenziswa kwe-intradermal. Unokuthelekisa ezinye izinto ezisebenzayo ngokupheleleyo uluhlu lwesitofu sokwenza mhlophe.

Iingqwalasela zoKhuseleko

I-Intradermal TXA inerekhodi ekhuselekileyo yokhuseleko kwizifundo ezipapashiweyo, kodwa ukusetyenziswa ngoxanduva kusaxhomekeke kwimveliso kunye nogqirha.

• Ubunyumba kunye nolawulo lwepyrogen alunakuxoxisana ngayo nayiphi na into etofwayo. Iimveliso ezenziwe kakubi zingumngcipheko omkhulu wehlabathi lokwenyani kunesithako esisebenzayo ngokwaso.

• Iimpendulo zasekuhlaleni ezifana ne-erythema, ukutshisa, ukugruzuka kunye nokudumba okwexeshana zezona ziphumo bezingalindelekanga zixelwa kakhulu.

• Umngcipheko wenkqubo uxoxwa kakhulu kwi-TXA yomlomo, efikelela kumanqanaba aphezulu egazi. Ukuvavanyelwa umngcipheko wokujiya kuseyinto elungileyo phambi kokutofa.

• Ubume bolawulo buyohluka ngokwamazwe. Kwiimarike ezininzi, izisombululo ze-mesotherapy ze-TXA zithengiswa njengezinto zokuthambisa okanye zesixhobo sonyango kunokuba zibe ngamachiza. Iiklinikhi kufuneka zijonge imithetho yendawo phambi kokuba isetyenziswe.

Ukufumana izisombululo ze-TXA ze-Mesotherapy: Uluhlu lokuHlola lwaBasasazi  kunye neempawu zeklinikhi

Imfuno yemveliso ye-TXA yomelele kwiimarike ezinamazinga aphezulu e-melasma, kuquka i-Asia-mpuma ye-Asia, uMbindi Mpuma, i-Latin America kunye neendawo zaseYurophu. Ukuba uceba ukungenisa elizweni okanye bucala-ileyibhelishe ifomyula ye-TXA, khangela:

1. Ukwenziwa elubala kwefomula: uluhlu olupheleleyo lwesithako olunogxininiso oluchaziweyo, hayi nje 'i-TXA complex'.

2. Imigangatho yokuvelisa: ISO 13485 kunye nemveliso ehambelana ne-GMP, kunye neerekhodi zebhetshi.

3. Uxwebhu: isatifikethi sokuhlalutya (i-COA), ingxelo yovavanyo lwe-sterility kunye ne-endotoxin, kunye nokuzinza kunye nedatha yobomi beshelufu kwibhetshi nganye.

4. Ukhetho lokupakisha: ubungakanani bebhodlela, ubungakanani bebhokisi kunye nokuleyibhile ezihlangabezana neemfuno zobhaliso lwemarike ekujoliswe kuyo.

5. Ukwenza ngokwezifiso: ingaba umenzi unokulungelelanisa umxube osebenzayo, umzekelo, i-TXA ene-PDN kunye ne-TXA ene-glutathione, kwindawo yakho.

I-AOMA ixhasa abasasazi kunye neempawu zeklinikhi ngokuqulunqa, ukuzaliswa kunye nokupakishwa kweleyibhile yangasese. Funda ngakumbi malunga wethu isiko mesotherapy OEM izisombululo.

FAQ

Ngaba inaliti ye-tranexamic acid iyasebenza ekwenzeni mhlophe ulusu?

I-TXA ichazwa ngcono njengesithako solawulo lwe-pigment kune-ejenti 'emhlophe'. Uphononongo lweklinikhi lubonisa ukuba inokunciphisa ubuqatha be-melasma kunye nethoni engaphandle, kodwa ayitshintshi umbala wolusu lwendalo lomntu.

Zingaphi iiseshini ze-TXA mesotherapy ezifunekayo kwi-melasma?

Uninzi lwezifundo zibandakanya iiseshini ezi-4 ukuya kwezi-8 eziqelelene iveki enye ukuya kwezine, kuxhomekeke kwiprothokholi kunye nemveliso. Uphuculo olubonakalayo kwizifundo ezipapashiweyo luvele malunga neeveki ze-8-12.

Ngaba i-TXA mesotherapy ingcono kune-oral tranexamic acid?

Bakhonza iinjongo ezahlukeneyo. I-Oral TXA liyeza elimiselweyo kunye neziphumo zenkqubo kwaye ifuna ukongamela ugqirha. I-Intradermal TXA ihambisa idosi encinci yendawo ngokuthe ngqo kwisilonda. I-dermatologist inokudibanisa zombini kwiimeko ezixhathisayo.

Ngaba i-melasma ingabuya emva konyango lwe-TXA?

Ewe. I-Melasma ayipheli kwaye ibangelwa ukukhanya kwe-UV, ubushushu kunye neehomoni. Ukukhuselwa kwelanga lemihla ngemihla kunye neeseshoni zokugcinwa kwamaxesha ngamaxesha ziyafuneka ukuze kugcinwe iziphumo.

Ngaba i-TXA inokudityaniswa nelaser okanye amaxolo?

Iingcali ezininzi zisebenzisa i-TXA ecaleni kwamaxolo athambileyo okanye iilaser ezinamandla aphantsi. Unyango kufuneka lubekwe ngokufanelekileyo kwaye lucwangciswe yingcali eqeqeshiweyo ukunqanda ukucaphuka kunye ne-pigmentation ephindwe kabini.

IiReferensi: Lee JH, Park JG, Lim SH, et al. I-intradermal microinjection yendawo ye-tranexamic acid yonyango lwe-melasma kwizigulane zase-Asia: ulingo lokuqala lweklinikhi. Dermatol Surg. 2006;32(5):626–631. Budamakuntla L, Loganathan E, Suresh DH, et al. I-randomized, i-open-label, isifundo sokuthelekisa i-tranexamic acid microinjections kunye ne-tranexamic acid ene-microneedling kwizigulane ezine-melasma. J Cutan Aesthet Surg. 2013;6(3):139–143.

Eli nqaku lelolwazi lwengcali kuphela kwaye ayilona cebiso lonyango. Unyango kufuneka lwenziwe ngabasebenzi abaqeqeshiweyo ngokuhambelana nemimiselo yendawo.