外用5%氨甲环酸联合激光治疗黑眼圈的疗效及安全性研究

The Efficacy and Safety of Topical 5%Tranexamic Acid Combined with Laser in the Treatment of Dark Eye Circles

目的:评价单独使用含5%氨甲环酸的护肤品及联合不同激光治疗以色素型为主的黑眼圈的疗效和安全性。方法:选择色素型及混合型黑眼圈患者32例,双侧上下眼睑用含5%氨甲环酸的护肤品3个月,同时一侧下眼睑接受皮秒激光治疗,另一侧下眼睑接受Q开关1064nm激光治疗,分别在第0、28、56天接受治疗。在第0、14、28、56、84天进行随访,以治疗前作为对照,皮肤颜色测量仪检测疗效,并采用患者自身评价观察黑眼圈改善情况。结果:单独使用含5%氨甲环酸护肤品后56d开始皮肤黑素指数、14d开始红斑指数比较,较使用前显著改善(P<0.05),且随使用时间延长效果更好。联合使用含5%氨甲环酸护肤品及Q开关1064nm激光后28d开始黑素指数及红斑指数比较,均较治疗前有显著下降(P<0.05),且随治疗次数增加效果更好。联合使用含5%氨甲环酸护肤品及755nm皮秒激光治疗后28d开始黑素指数、14d开始红斑指数比较,均较治疗前有显著下降(P<0.05)。所有就医者自我评价均认为黑眼圈的颜色及范围得到一定程度改善,其中超过50%的就医者认为得到了中度至显著改善效果。试验过程中约13.8%的就医者使用护肤品时出现局部红斑、瘙痒等不良反应,停用产品后均可自行缓解。Q开关激光治疗不良反应轻微,皮秒激光治疗过程中有轻、中度疼痛,术后即刻可出现明显红斑。结论:对于以色素型为主的黑眼圈外用含5%氨甲环酸的护肤品可改善黑眼圈的颜色及范围,偶可见局部刺激反应;联合Q开关1064nm或755nm皮秒激光治疗可改善黑眼圈的颜色及范围,起效更快,并减少激光治疗后色素沉着的发生几率,安全性好。

Objective To determine the efficacy and safety of using a gel containing 5%tranexamic acid,gel combining with Q-switched 1064nm laser or 755nm picosecond laser in pigmented and mixed type of dark eye circles.Methods For pigmented and mixed type of dark eye circles,the participants applied a gel containing 5%tranexamic acid to upper and lower eyelids for 84 days,and lower eyelid of one side was treated with Q-switched 1064nm Nd:YAG laser,another side was treated with 755nm picosecond laser.All kinds of laser treated in two treatment sessions at 4 week intervals.Patient follow-up was done at baseline,Day14,Day28,Day56 and Day84.Clinical effects were evaluated by MX18.We also evaluated treatment tolerance and investigate patients’satisfaction at every follow-up.Results Compared with baseline,the melanin index(MI)and erythema index(EI)in product group both had a significant decrease(P<0.05),and the efficacy increased with time.The product combined with laser treatment also got good improvement without obvious adverse reaction.13.8%(4/29)patients occurred dermatitis while using the gel.No obvious pain and erythema occurred during treatment of Q-switched laser,mild pain and obvious erythema occurred during treatment of picosecond laser.Conclusion Topical use of 5%tranexamic acid can effectively improve pigmented and mixed type of dark circles,there were few side effects.Combination of topical product with Q-switched laser or picosecond laser is also effective,and it can reduce the incidence of post-inflammatory hyperpigmentation.