Fractional Erbium YAG Laser vs Intradermal and Systemic Tranexamic Acid

NCT ID: NCT06522984

Last Updated: 2024-07-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

45 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-06-01

Study Completion Date

2025-06-10

Brief Summary

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Melasma is a common acquired disorder of hyperpigmentaion caused by increased melanin production by melanocytes.

Melasma is a name derived from the Greek word melas meaning black.It is characterized by the appearance of brownish or grayish symmetrical patches on sun-exposed skin, most commonly on the face. Compared to men, women are more likely to be affected.

Detailed Description

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Melasma is more common in people with dark complexions and Fitzpatrick skin types III IV.Depending on ethnicity and region, melasma prevalence might vary from 8.8% to 40%. The cause of melasma is still unknown in the meantime.

Numerous elements, including genetics, sunshine, endocrine stimulation, oxidative conditions,pregnancy, exogenous hormons,and morphofunctional changes, may have a role in the development of the disease.

Since melasma is a common skin condition affecting mostly pregnant women and those on hormonal birth control, it is known as the "mask of pregnancy,

Treatment for melasma remains a challenge, with substantial psychosocial ramifications. Many factors, including variability in clinical presentation and responsiveness to treatment between genders, skin phototypes, and ethnicities, can affect treatment efficacy. None of variety methods have been sufficiently effective to be considered the gold standard.

Hydroquinone (HQ) has historically been the most studied topical agent in the treatment of melasma. HQ is a hydroxyphenolic compound that inhibits the conversion of dopa to melanin by the inhibition of tyrosinase; it also inhibits RNA and DNA synthesis of melanocytes and degrades melanosomes.

Tranexamic acid (TXA) is an antifibrinolytic drug that has been used off-label for the treatment of melasma, as an oral or intradermal injection.

TXA is a lysine-derived amino acid with anti-inflammatory effects that prevents ultraviolet (UV)-induced skin pigmentation by inhibiting attachment of plasminogen to keratinocytes and activation of plasmin. Plasmin stimulates melanogenesis by conversionof arachidonic acid to prostaglandin and leukotriene. On the other hand, plasmin increases the level of melanogenic factors.

Laser therapy is a unique ablative modality that might potentially increase the penetration of medications applied topically by destroying the SC, epidermal, and dermal layers of the skin in a predictable and controlled manner.

The Fractional erbiumdoped yttrium aluminum garnet (Er: YAG) laser has a wavelength of 2,940 nm and is strongly absorbed by water in the epidermis. It exerts its ablation effect with minimal penetration depth and minimal heat generation and therefore minimal thermal damage.

Conditions

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Refractory Melasma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Group A

About 15 cases will receive sessions with fractional Er: YAG laser every 3 weeks followed by application of topical 4% (HQ) cream.

Group Type ACTIVE_COMPARATOR

Tranexamic acid injection

Intervention Type DRUG

to evaluate and compare efficacy of:

* Fractional Er: YAG laser combined with topical hydroquinone.
* Intradermal injection of tranexamic acid combined with topical hydroquinone cream.
* Oral administration of tranexamic acid combined with topical hydroquinone cream. In treating refractory melasma.

Group B

About 15 cases will receive sessions of intradermal injection of tranexamic acid on the melasma site every 3 weeks concurrently with the application of topical 4% HQ cream every night. The injections will be done using an insulin syringe with a dilution of the tranexamic acid

Group Type ACTIVE_COMPARATOR

Tranexamic acid injection

Intervention Type DRUG

to evaluate and compare efficacy of:

* Fractional Er: YAG laser combined with topical hydroquinone.
* Intradermal injection of tranexamic acid combined with topical hydroquinone cream.
* Oral administration of tranexamic acid combined with topical hydroquinone cream. In treating refractory melasma.

Group C

About 15 cases will receive oral tranexamic acid 500mg tablet once daily for three months. And will also be asked to apply a thin layer of topical HQ 4% cream on the hyperpigmented areas once every night.

Group Type ACTIVE_COMPARATOR

Tranexamic acid injection

Intervention Type DRUG

to evaluate and compare efficacy of:

* Fractional Er: YAG laser combined with topical hydroquinone.
* Intradermal injection of tranexamic acid combined with topical hydroquinone cream.
* Oral administration of tranexamic acid combined with topical hydroquinone cream. In treating refractory melasma.

Interventions

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Tranexamic acid injection

to evaluate and compare efficacy of:

* Fractional Er: YAG laser combined with topical hydroquinone.
* Intradermal injection of tranexamic acid combined with topical hydroquinone cream.
* Oral administration of tranexamic acid combined with topical hydroquinone cream. In treating refractory melasma.

Intervention Type DRUG

Other Intervention Names

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Fractional erbium YAG laser

Eligibility Criteria

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Inclusion Criteria

\- Patients of both sexes with melasma.

Exclusion Criteria

* Pregnancy
* Lactation
* Administration of oral contraceptive pills or any phototoxic drug within 1 month prior to study
* Patients with a history of thrombosis, abnormal bleeding profile, known hypersensitivity to TA or HQ, and endocrinal disease.
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Aswan University

OTHER

Sponsor Role collaborator

Egymedicalpedia

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Moustafa Adam Ali El Taieb, Professor

Role: STUDY_CHAIR

Dermatology, Venereology and Andrology.Faculty of Medicine, Aswan University

Locations

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Aswan University hospitals

Aswān, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Heba Allah Mohamed Mustafa, Resident

Role: CONTACT

+201151182890

Moustafa Adam Ali El Taieb, professor

Role: CONTACT

+201092991101

Facility Contacts

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Mahmoud Ahmed Ali, M.D

Role: primary

+201002364902

Mohamed Amer Ahmed Abdellatif, M.D

Role: backup

+201060394083

Other Identifiers

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Heba Allah Mohamed Mustafa

Identifier Type: -

Identifier Source: org_study_id

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