Arbutin + Kojic Acid + Magnesium + Mulberry extract + Tranexamic Acid + Vitamin E

Usage

This combination of ingredients is primarily used topically for the treatment of melasma and hyperpigmentation. It aims to lighten darkened skin patches and achieve a more even skin tone. It is considered a skin-lightening agent.

Alternate Names

This combination does not have a single, universally recognized international nonproprietary name (INN). It is often referred to by the names of its constituent ingredients. Several brand names exist, including Tyrodin, Kromaglo, Melano-TX, Melanorm TX, and Spekzo TX.

How It Works

This topical formulation exerts its effects through multiple mechanisms involving its various components:

• Tranexamic acid: Inhibits plasmin, a protein involved in inflammation, which can contribute to melanocyte activation and melanin production. It also offers some UV protection.

• Kojic acid: A tyrosinase inhibitor derived from fungi. Tyrosinase is a key enzyme in melanin biosynthesis. By inhibiting tyrosinase, kojic acid reduces melanin production.

• Arbutin: Another tyrosinase inhibitor, derived from the bearberry plant. It further contributes to reducing melanin synthesis.

• Magnesium ascorbyl phosphate (MAP): A stable form of vitamin C, acting as an antioxidant that protects against UV damage and may also inhibit melanin production.

• Vitamin E (tocopherol acetate): An antioxidant that protects against UV-induced damage, which can trigger melanogenesis. It also supports skin barrier function.

• Mulberry extract: Possesses antioxidant and tyrosinase-inhibiting properties, contributing to the overall skin-lightening and anti-aging effects.

The pharmacokinetics of this topical combination have not been extensively studied. Absorption through the skin is expected to be limited, but some systemic absorption of certain components, like tranexamic acid, is possible.

Dosage

Standard Dosage

This medication is for topical use only.

Adults:

Typically, a thin layer of the cream is applied to the affected areas once or twice daily. Specific dosing instructions can vary depending on the formulation’s strength and the physician’s recommendation.

Children:

Use in children should be under the guidance of a dermatologist.

Special Cases:

• Elderly Patients: No specific dose adjustments are typically required.
• Patients with Renal/Hepatic Impairment: While systemic absorption is limited, caution is advised. Dosage adjustments may be necessary depending on the severity of impairment and the specific product.
• Patients with Comorbid Conditions: Use with caution in patients with a history of thromboembolic events (especially with tranexamic acid), active skin infections, or allergies to any of the ingredients.

Clinical Use Cases

The combination is not typically used in clinical settings like intubation, surgery, mechanical ventilation, or the ICU, as its primary indication is melasma.

Dosage Adjustments

Adjustments may be needed based on individual patient response and tolerance. Start with a low frequency of application and gradually increase as tolerated.

Side Effects

Common Side Effects:

• Skin irritation
• Redness
• Itching
• Dryness
• Increased sun sensitivity

Rare but Serious Side Effects:

• Allergic reactions (e.g., contact dermatitis)

Contraindications:

• Hypersensitivity to any of the ingredients
• Active skin infection or inflammation at the application site
• Concomitant use of hormonal contraceptives (as they may exacerbate melasma)

Drug Interactions:

• Topical retinoids, exfoliants: May increase skin irritation
• Photosensitizing agents (e.g., tetracyclines): May increase sun sensitivity
• Hormonal contraceptives: May worsen melasma

Pregnancy and Breastfeeding

The safety during pregnancy and breastfeeding has not been definitively established. Consult a physician before use.

Drug Profile Summary

• Mechanism of Action: Multifaceted, involving tyrosinase inhibition, anti-inflammatory action, antioxidant properties, and UV protection.
• Side Effects: Primarily skin irritation, redness, itching, dryness, and photosensitivity.
• Contraindications: Hypersensitivity, active skin infection, concomitant use of hormonal contraceptives.
• Drug Interactions: Topical retinoids, exfoliants, photosensitizing agents, hormonal contraceptives.
• Pregnancy & Breastfeeding: Consult a physician before use. Insufficient data for safety.
• Dosage: Topical application to affected area(s) once or twice daily.
• Monitoring Parameters: Observe for skin irritation or allergic reactions.

Popular Combinations

Often formulated with other skin-brightening agents like vitamin C, niacinamide, or licorice extract.

Precautions:

• Perform a patch test before applying to a larger area.
• Avoid contact with eyes and mucous membranes.
• Use sunscreen daily and limit sun exposure.
• Discontinue use if severe irritation occurs.

FAQs

Q1: What is the recommended dosage for Arbutin + Kojic Acid + Magnesium + Mulberry extract + Tranexamic Acid + Vitamin E?

A: Apply a thin layer to the affected area(s) once or twice daily, as directed by a physician.

Q2: Can this combination be used during pregnancy or breastfeeding?

A: Consult a physician before use during pregnancy or breastfeeding, as safety data is limited.

Q3: What are the common side effects?

A: Common side effects include skin irritation, redness, itching, dryness, and increased sun sensitivity.

Q4: How long does it take to see results?

A: Improvement may be gradual, taking several weeks or months of consistent use to see noticeable results.

Q5: Can this combination be used with other skincare products?

A: Use caution when combining with other topical products, especially retinoids and exfoliants, as they may increase irritation. Consult a dermatologist for guidance.

Q6: Is it safe to use on all skin types?

A: While generally suitable for various skin types, individuals with sensitive skin should perform a patch test before use and start with a lower frequency of application.

Q7: Does this combination treat acne?

A: While it may help improve post-inflammatory hyperpigmentation from acne, it’s not a primary acne treatment.

Q8: Should sunscreen be used with this combination?

A: Yes, daily sunscreen use is crucial, as some ingredients can increase sun sensitivity.

Q9: What should I do if I experience irritation?

A: Discontinue use and consult a dermatologist. Reducing the frequency of application or switching to a gentler formulation may be recommended.