Clinical observation and dermoscopy evaluation of fractional CO₂ laser combined with topical tranexamic acid in melasma treatments

Abstract

Background Melasma is an acquired refractory pigmentary disorder, which is a skin disease that predominantly affects females. This investigation aims to assess the efficacy of a low‐power fractional CO2 laser combined with tranexamic acid (TXA) for melasma topical treatment with MASI and dermoscopy. Materials and Methods A randomized comparative split‐face study was performed. Each treatment interval was 3 weeks with four times in total. At the same time, we applied TXA solution twice a day. Assessments were made by the MASI score of the melasma area severity index, and the dermoscopy performance was collected and analyzed. Results After treatments, the patient MASI score decreased significantly. Compared with the baseline, the MASI score was significantly lower than that of control group (P < .05), and the decrease ratio was higher than that of controls. Dermoscopy examination results verified that all lesions performed reticuloglobular pattern, granular, or punctate, with no structural pigmentation and obvious capillary dilation. After comprehensive treatments, the pigmentation area displayed lighter chroma, the follicle pore uniformity was completely improved, and the capillary dilation was significantly reduced. Conclusions Low‐power fractional CO2 laser combined with topical TXA solution is a comparatively effective and safe method for melasma treatment. TXA could reduce the dilation of blood vessels.

Efficacy and safety of laser‐related therapy for melasma: A systematic review and network meta‐analysis

“…Then, by screening the titles and abstracts, we further eliminated 793 studies. Ultimately, 39 randomized clinical trials 12,18–55 were included in the network meta‐analysis. The flowchart of screening and selection is depicted in Figure 1.…”

Tranexamic Acid Microinjection Alone Versus Its Combination With Fractional Carbon Dioxide Laser in Melasma Treatment: A Dermoscopic Evaluation

“…Qu and colleagues 27 compared using fractional CO 2 laser in addition to topically applied TXA solution versus using topically applied TXA solution alone for the treatment of melasma. A significantly better response in the combined treatment group was reported, contrary to this study.…”

Laser-assisted delivery of vitamin c or vitamin c plus growth factors in the treatment of chloasma in women: a systematic review and meta-analysis

“…Fractional, CO 2 , Q-switched (Nd:YAG), and (Er:YAG) lasers were used to deliver agents in these studies. Three studies did not specify the vitamins used (Ooe et al, 2013;Qu et al, 2021;Robati and Asadi, 2017). At the same time, vitamin C remained the dominant type of vitamin used in the majority of studies.…”

“…Of these 45 studies, 21 discussed lasers related to other topics, 16 were out of scope, and growth factor GFs. (Alvin et al, 2011;Badawi and Osman, 2018;Choi et al, 2015;Handog et al, 2009;Kim et al, 2020;Lima et al, 2017;Qu et al, 2021;Ustuner et al, 2017). The Melasma area and severity index (MASI) values were used for the control and experimental groups.…”