Tranexamic acid combined with glutathione compound water light whitening spot should how to match

In clinical work, tranexamic acid is often combined with glutathione, VC and water to treat melasma or whitening skin.

At this time, how should the ratio be?

When operating, what are the precautions?

Mechanism of tranexamic acid

It is an anti-fibrinolytic drug, has a hemostatic effect, and is widely used in clinical treatment of various bleeding.

Tranexamic acid, also known as hemostatic cyclic acid, in Taiwan, China, also known as tranexamic acid.

Why can it be used in the field of medical beauty?

This is because the formation of melanin in melasma is due to the activation of tyrosinase in melanocytes after the skin is stimulated by ultraviolet light, and tyrosinase catalyzes the production of tyrosine dopa and finally evolves into melanin, and melanin transfers to the skin surface to form spots.

Tranexamic acid can compete with tyrosinase, inhibit its catalytic effect on tyrosinase, and reduce the formation of melanin.

At the same time, tranexamic acid can also inhibit the transport and diffusion of melanin, so as to dilute the role of color spots.

According to the Expert Consensus on photoelectric Treatment and Repair of melasma, systematic drug use is not the first choice for the treatment of melasma, and in most cases it is used for hyperindication.

Intravenous administration is effective, and oral efficacy is generally weak.

Common programs: intravenous injection of vitamin C, glutathione combined with vitamin C, tranexamic acid, etc., tranexamic acid is effective orally.

Glutathione consists of glutamic acid, cysteine and glycine. Glutathione is mainly involved in the cycle of tricarboxylic acid and glucose metabolism in the human body. It can activate lucidase, activate REDOX system and detoxify the body.

According to the Consensus of Chinese melasma Diagnosis and Treatment Experts (2021 edition), the thiol group in glutathione molecules can inhibit its activity by binding with copper ions in tyrosinase and reduce melanin production, which can be orally or intravenously injected and is often combined with vitamin C.

Clinical effect of tranexamic acid and glutathione

In A study, 135 patients with melasma were selected and randomly divided into three groups, A, B and C, with 45 cases each.

Group A was given laser treatment alone, YAG laser therapy instrument was selected, wavelength 1064nm, frequency 10Hz, spot diameter 8mm, energy density 1.0-1.5j/cm-2.

The energy is adjusted according to the patient’s skin type, skin sensitivity, skin lesions and color depth. Hold the output end of the laser machine, irradiate the skin surface vertically, first shoot the skin 2-3 times, observe the local reaction for 3 ~ 5min, and the energy density gradually increases from low to high, with slight skin redness as the degree;

Then the uniform speed of the treatment area 2 ~ 3 times, once every 2 weeks, a total of 3 treatment.

Patients in group B were given 0.25g tranexamic acid, 1.2g glutathione, 4g vitamin C plus 200 ml5% glucose solution intravenously, twice a week for 6 weeks.

Group C was treated with laser, tranexamic acid, glutathione and vitamin C in the same way as group A and group B.

Clinical results showed that all three groups of treatment were effective.

There was no significant difference in treatment effect between group A and group B;

The treatment of group C was significantly different from that of group A and group B. The study showed that tranexamic acid and glutathione were effective in the treatment of melasma, and the combined laser treatment was more effective.

Administration and combination of tranexamic acid and glutathione

In general, the combination of tranexamic acid and glutathione is given by water and light, intravenous drip, oral or wet compress.

There are many contraindications for intravenous infusion, and we generally recommend water and light introduction or oral treatment, which has better effect and is relatively simple to operate.

Water and light combination method

Tranexamic acid generally has two specifications that are more common, one is 0.25g,5ml5 bottles, and the other is 0.1g,2ml10 bottles.

Generally, a dose of 0.1g to 0.2g is sufficient.

The reduced glutathione (0.6g) is a white powder, which can be mixed with 3-4ml normal saline first, and then pumped with 1-1.5ml water light.

Oral therapy

Oral tranexamic acid tablet, 0.25g/ tablet, twice a day

Reduced glutathione tablet, 0.3g/ tablet, 3 times/day

Course of treatment: 1 month is 1 course of treatment, and appropriate extension of treatment for patients with insignificant curative effect.

Sum up

1. Tranexamic acid and glutathione are not suitable for compounding with water light with relatively thin viscosity, and the leakage is more serious.
2. Antioxidant drugs are the main types of drugs used in the treatment of melasma, among which glutathione is more widely used. It has high antioxidant and integrated detoxification effects, which can fight against free radicals in the body, promote the discharge of toxins and metabolic waste, and inhibit the formation of melanin and promote its decomposition.

Although glutathione has a certain therapeutic effect on melasma, there is still a certain gap from the eradication effect, and further improvement of the treatment plan is needed.