Efficacy, effectiveness, and safety of combination laser and tranexamic acid treatment for melasma: A meta-analysis

Background

Melasma is an acquired pigmentation condition characterized by its refractory nature and a high risk of recurrence. Treatment of melasma is challenging owing to its unclear etiology, stubborn resistance to treatment, and frequent relapses. Therefore, this study aimed to compare the efficacy, effectiveness, and safety of monotherapy and combination therapy (combination of laser and tranexamic acid (TXA)) for the treatment of melasma using a network meta-analysis.

Method

The PRISMA guidelines were used in this meta-analysis, with a literature search conducted in reputable sources, such as Cochrane, Science Direct, PubMed, and Google Scholar.

Results

From the initial search, 1 504 relevant studies were identified. After careful analysis, three studies were included in the meta-analysis. The results showed no significant differences in the Melasma Area and Severity Index (MASI) score between monotherapy (control group) and a combination therapy of laser and TXA. The mean difference in MASI score was 1.87 (95% confidence interval (CI), −0.78–4.52; P=0.17), indicating no significant difference between the two treatment approaches. Side effects were more common in the combination treatment group than in the control group. The odds ratio for experiencing side effects was 8.85 (95% CI, 1.57–50.01; P=0.01).

Conclusion

Both the monotherapy and combination therapy groups showed therapeutic improvement; however, the combination therapy group showed a higher incidence of side effects.