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Melasma is a localized, acquired hyperpigmentary skin disorder characterized by well-defined, light to dark brown patches. Based on clinical practice and extensive literature reports, tranexamic acid and reduced Glutathione (GSH) are both applied in the treatment of melasma, but their water-soluble nature presents challenges for transdermal absorption. Our preliminary basic and clinical research has demonstrated that ultrasound-assisted delivery significantly enhances the absorption of tranexamic acid and other water-soluble components. Its effect on the skin barrier is temporary and reversible.
This study aims to evaluate the efficacy and safety of a compound solution (10% tranexamic acid, 2% GSH) delivered via ultrasound for melasma treatment through a split-face controlled trial.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Topical treatment with Ultrasound | Experimental | 10%TXA+2%Reduced Glutathione applied via ultrasound at 5W/cm² for 10mins |
|
| Topical treatment without Ultrasound | Other | 10%TXA+2%Reduced Glutathione applied via ultrasound at 0W/cm² for 10mins |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 10%TXA+2%Reduced Glutathione applied via ultrasound at 5W/cm² in10min | Device | 5w/cm² Ultrasound-assisted topical application of 10% tranexamic acid and 2% reduced glutathione for 10 mins |
| Measure | Description | Time Frame |
|---|---|---|
| percentage reduction in hemi-MASI | mean percentage reduction in hemi-MASI from baseline to week 20 | From enrollment to the end of treatment at 8 weeks, and 4&12 weeks after the final intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Patient self-assessment | The outcomes were categorized as follows: cured (improvement ≥75%), markedly effective (improvement 50%-75%), effective (improvement 25%-50%), and ineffective (improvement ≤25%). The satisfaction rate was calculated as: Satisfaction rate = (number of cured + markedly effective + effective cases) / total number of cases × 100% | week 4 during treatment and the end of treatment at 8 weeks, and 4&12 weeks after the final intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Two-Photon Microscopic Imaging | This was to monitor experimental safety and the impact on the skin barrier. | The enrollment, week 4 during treatment and the end of treatment at 8 weeks, and 4&12 weeks after the final intervention |
| Dermatoscopy |
Inclusion Criteria:
-(1) Male or female participants aged 20 to 55 years (inclusive); (2) Subjects clinically diagnosed with melasma and confirmed by the investigator to meet the trial requirements; (3) Subjects willing to comply with follow-up observations and able to provide portrait rights for documentation purposes; (4) Understanding and willingness to participate in the clinical trial, and voluntarily signing a written informed consent form.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Lu Yan, phD | Contact | 13913967126 | luyan6289@163.com | |
| Lu Yan, phD | Contact | Overall Study |
| Name | Affiliation | Role |
|---|---|---|
| Lu Yan | The First Affiliated Hospital with Nanjing Medical University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The first Affiliated hospital with Nanjing medical university | Recruiting | Nanjing | Jiangsu | 210009 | China |
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| ID | Term |
|---|---|
| D008548 | Melanosis |
| ID | Term |
|---|---|
| D017495 | Hyperpigmentation |
| D010859 | Pigmentation Disorders |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| 10%TXA+2%Reduced Glutathione applied via ultrasound at 0W/cm² 10min | Other | topical application of 10% tranexamic acid and 2% reduced glutathione for 10 mins |
|
| Clinical Efficacy | investigators evaluated the melasma or hyperpigmentation on split-face using the following criteria: Cured: >90% reduction in pigmented area with virtually disappearance of color upon visual inspection. Markedly Effective: >60% reduction in area with significant lightening of color. Effective: >30% reduction in area with noticeable lightening of color. Ineffective: <30% reduction in area with no significant change in color. The effective rate was calculated as: Effective rate = (number of cured + markedly effective + effective cases) / total number of cases × 100%. | week 4 during treatment and the end of treatment at 8 weeks, and 4&12 weeks after the final intervention |
| VISIA Digital Skin Analysis | From enrollment to the end of treatment at 8 weeks, and 4&12 weeks after the final intervention |
| Melasma Quality of Life Scale (MELASQOL) Score | The enrollment, week 4 during treatment and the end of treatment at 8 weeks, and 4&12 weeks after the final intervention |
| The enrollment, week 4 during treatment and the end of treatment at 8 weeks, and 4&12 weeks after the final intervention |