Low-Fluence Q-Switch 1064 Nm Laser Combined With Oral Tranexamic Acid: A Quicker Treatment for Laser-Induced Postinflammatory Hyperpigmentation

Abstract

Background and Purpose

Laser-induced post-inflammatory hyperpigmentation (PIH)is a common adverse reaction in Asian individuals. Dark skin and incorrect laser parameters are common causes, but PIH is often unexpected for patients. Obvious hyperpigmentation can lead to an ugly appearance and severe anxiety. Therefore, a fast and effective treatment for laser-induced PIH is necessary. In this article, we attempted to demonstrate that a low-fluence Q-switch (QS) 1064 nm laser combined with oral tranexamic acid (TXA) is a quick and safe method for the clearance of laser-induced PIH.

Materials and Methods

A retrospective cohort study, adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, spanning 2 years (2021–2023) was conducted on 23 patients aged between 29 and 58 years. These patients were diagnosed with laser-induced PIH for < 3 months. The treatment regimen was a low-fluence QS1064 nm laser combined with oral TXA, oral TXA was first taken, and a low-fluence QS1064 nm laser was used for at least 1 month after the last laser was applied. Three to six laser treatments were subsequently applied. After treatment, the pigment color and patient satisfaction were assessed to evaluate the effectiveness of the treatment options.

Results

Twenty patients were enrolled in the study, the average laser treatments were 4.3 ± 0.865 times. The Melasma Area and Severity Index (MASI) score decreased from 9.325 ± 3.38 before treatment to 5.97 ± 2.37. After the first treatment, the MASI score decreased by approximately 40%. Two months after the last treatment, the MASI score decreased to 0.93 ± 1.06, and there was a statistically significant difference in the MASI score before and after treatment (p < 0.05). Patient satisfaction scores revealed that 95% of patients were highly or strongly satisfied with the decrease in the intensity of the PIH color, with a moderate response rate of 1 (5%). The patients thought that the pigment removal speed was 75% (15) very fast or fast, 20% (4) moderate, and 5% (1) slow.

Conclusion

The results of this study demonstrated the quick and safe removal of laser-induced PIH following treatment with low-fluence QS1064 nm laser combined with oral TXA. Providing such a protocol is indeed one of the primary objectives of this article.