Combinational therapy, such as tranexamic acid with laser, has been proven to have conceivable effectiveness in many experiments. However, there is very little literature that contains large samples and consistent observations.

The present study evaluated the clinical efficacy and safety of a new systemic treatment of drug-laser-photon therapy (tranexamic acid with Q-switched Nd:YAG laser).

It analyzed 75 patients with mixed-type melasma. At each visit, the researchers obtained standardized photographs using VISIA. Two dermatologists marked modified melasma area and severity index (mMASI) scores using photographs.

The dermatologists observed the following:

• Significant decrease in the mMASI score from 6.92 to 3.84 after the treatment. 
• Significant increase in the spots, ultraviolet (UV) spots and brown spots by VISIA analysis of right cheek data.
• Varying degrees of improvement in all patients; approximately 10.17% felt very much improved, 30.51% felt much improved, 45.76% felt moderately improved and 13.56% felt little improved.

This study proves the efficacy and safety profile of the combination of drug-laser-photon therapy systemic treatment in melasma patients. Thus, this combination can potentially become a new, reliable, widely suitable therapy strategy.

Source: Li Y, Shao WN, Fang QQ, et al. A combination treatment of drug-laser-photon for melasma: a retrospective study of clinical cases. J Cosmet Dermatol. 2023;22(3):822-30.