الفهرس | Only 14 pages are availabe for public view |
Abstract Melasma (or chloasma) is an acquired, benign and highly ubiquitous skin disorder with chronic hyper melanosis, characterized by symmetrical patches and macules exhibiting light to dark-brown color. Although the etiology of melasma is not definitely well-understood, some risk factors such as sun exposure, cosmetics, hormonal therapies, contraceptive pills, pregnancy, photosensitizing agents, genetic susceptibility and anti-seizure remedies represent the utmost provoking factors to such disorder. Vitamin C, a potent antioxidant and radical scavenger, interferes with melanogenesis by inhibiting oxidative reactions in the process of melanin formation. When used as a monotherapy or in combination with other agents, it lightens the skin. Nanotechnology represents a very promising strategy exploited for the encapsulation of different hypo-pigmenting agents in an attempt to augment their physicochemical stability and enhance their penetrability to deeper skin layers for managing melasma of epidermal as well as dermal origin. Companies have developed stabilized vitamin C preparation. The stabilized preparation improves hydration and reduces wrinkles, glare, and brown spots, by reducing UV-induced collagen breakdown. In a randomized, double-blinded, placebo-controlled study, investigators used iontophoresis to enhance the penetration of vitamin C into the skin and significantly decreased pigmentation in patients with melasma. Chemical peels induce a controlled chemical burn of the skin that removes the epidermis with or without parts of the epidermis. This leads to removal of superficial skin lesions followed by regeneration of newer dermal and epidermal layers. TCA is a safe and economic peel to use. The more the frosting induced by TCA, the more the depth of its penetration is. Another advantage is the fact that TCA peels need no neutralization. This study aimed to assess the efficacy of topical nano vitamin C enhanced with iontophoresis and to compare its effect with topically applied TCA 20% chemical peeling in the treatment of melasma. To elucidate our results, this right-left comparative study was carried out on 30 female patients with their age ranging from 20 to 52 years, participated for treatment of facial melasma, with melasma duration ranging from 1 to 12 years selected from Outpatient clinic of Dermatology department Menoufia University Hospitals during the period from September 2020 to March 2021. |