Value of Q-switched 755-nm alexandrite laser combined with topical tranexamic acid in the treatment of melasma.

Abstract

Objective: To explore the clinical value of Q-switched 755-nm alexandrite laser combined with topical tranexamic acid in treating melasma.

Methods: A total of 121 melasma patients treated at AIST Medical Cosmetology Hospital from July 2022 to January 2024 were retrospectively included. They were divided into two groups: the Laser Treatment Group (LTG, n=61), receiving Q-switched 755-nm alexandrite laser combined with topical tranexamic acid, and the Control Treatment Group (CTG, n=60), receiving only topical tranexamic acid. Clinical efficacy, skin scores before and after treatment, laboratory indicators, melanin index, dermoscopic scores for pigmentation and vascular components, dermoscopic typing improvement, adverse reactions, and recurrence rates were compared.

Results: The treatment efficacy rate was 93.44% in the LTG, significantly higher than 81.67% in the CTG (P<0.05). After treatment, the LTG showed significantly lower Melasma Area and Severity Index (MASI) scores, skin lesion color, and area scores compared to the CTG (all P<0.05). No significant differences were found in malondialdehyde (MDA) and superoxide dismutase (SOD) levels (both P>0.05). The LTG had a lower melanin index and dermoscopic scores for telangiectasia and perifollicular pigmentation than the CTG (all P<0.05). The incidence of adverse reactions in the LTG was 11.48%, significantly lower than 40.00% in the CTG (P<0.05). The LTG also had a lower recurrence rate of 1.64% at 6-month follow-up, compared to 10.00% in the CTG (P<0.05).

Conclusion: Q-switched 755-nm alexandrite laser combined with topical tranexamic acid is highly effective in treating melasma, improving clinical symptoms, reducing oxidative stress and inflammation, and yielding better results in vascular proliferation and pigmentation. The treatment also demonstrated a low recurrence rate, suggesting its potential for broader use.