Q-Switched 1064 nm Fractional Laser with Intradermal Tranexamic Acid for Melasma: A Retrospective Propensity...

Area of Science:

• Dermatology
• Aesthetic Medicine
• Laser Therapy

Background:

• Melasma is a common hyperpigmentation disorder.
• Existing treatments for melasma have varying efficacy and safety profiles.
• Novel therapeutic approaches are needed for effective melasma management.

Purpose of the Study:

• To evaluate the efficacy and safety of combining Q-switched 1064 nm fractional laser with intradermal tranexamic acid (TXA) injection for melasma treatment.
• To compare the combination therapy against monotherapy with laser or TXA injection alone.

Main Methods:

• Retrospective study of 161 female patients with melasma.
• Propensity score matching to create three groups (30 patients each): laser alone, TXA alone, and combination therapy.
• Assessment using Melasma Area and Severity Index (MASI), VISIA parameters, and patient satisfaction.

Main Results:

• All treatment groups showed significant improvement in MASI scores and VISIA parameters (P < 0.001).
• The combination therapy group demonstrated superior reduction in MASI scores and pigmentation indices compared to monotherapy groups (P < 0.001).
• Higher patient satisfaction was observed in the combination group (OR = 3.82, P = 0.028); recurrence rates and adverse events were similar across groups.

Conclusions:

• Q-switched 1064 nm fractional laser combined with intradermal TXA injection is an effective treatment for melasma.
• Combination therapy offers enhanced clinical improvement and patient satisfaction compared to monotherapies.
• The treatment regimen is safe and well-tolerated with mild, transient side effects.