Efficacy and safety of tranexamic acid in the treatment of adult melasma: An updated meta‐analysis of randomized controlled trials

Feng, Xiaowei; Su, Hong; Xie, Jinwei

doi:10.1111/jcpt.13430

Cited by 25 publications

(17 citation statements)

References 50 publications

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“…31 Moreover, tranexamic acid (TA) has been proven to interrupt the interaction between melanocytes and keratinocytes; so, its combination with laser therapy may have an unexpected effect. 32 Therefore, we hypothesized that a combination of LQSNY and drugs might promote the efficacy of LQSNY treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Combined chemical stripping has been reported to enhance laser effects, as its deeper penetration depth causes more epidermal melanin shedding and avoids the adverse effects of multiple laser treatments 31 . Moreover, tranexamic acid (TA) has been proven to interrupt the interaction between melanocytes and keratinocytes; so, its combination with laser therapy may have an unexpected effect 32 . Therefore, we hypothesized that a combination of LQSNY and drugs might promote the efficacy of LQSNY treatment.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of low‐fluence 1064 nm Q‐switched Nd: YAG laser for the treatment of melasma: A meta‐analysis and systematic review

Chen

Peng

et al. 2022

J of Cosmetic Dermatology

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Background: Melasma is considered as a type of acquired facial pigmentary disorder that is challenging to treat. Low-fluence 1064 nm Q-switched Nd: YAG laser (LQSNY) has clinical benefits against melasma; however, there are some disputes.Objective: To explore these contentious views, we conducted a meta-analysis and systematic review to evaluate the efficacy and safety of LQSNY monotherapy and combined therapy for the treatment of melasma. Methods:The PubMed, Embase, Cochrane Library, and Web of Science databases were searched for relevant articles from inception to July 2021. The resulting data were analyzed using the Review Manager 5.3 software. Results:Twelve eligible studies comprising 358 patients were included. No significant differences in melasma area and severity index (MASI) were observed between the LQSNY and drug groups (mean difference (MD):−0.26, 95% confidence interval (CI):−1.16-0.64, p = 0.57). We found that combination therapy with LQSNY and drugs had a greater MASI improvement compared with LQSNY therapy alone (MD: 1.78, 95% CI 0.93-2.63, p < 0.0001); nevertheless, no statistically significant results were found in melanin index (MI) and self-assessment. The melasma improvement was similar when using LQSNY alone and LQSNY combined with other lasers in terms of RMASI (MD 0.05, 95% CI:−0.61, 0.70, p = 0.56). Compared with intense pulsed light (IPL) alone, LQSNY with IPL provided an added benefit for melasma severity (MD:3.23, 95% CI:0.65-5.81, p = 0.01). Conclusion:Low-fluence 1064 nm Q-switched Nd: YAG laser can be applied as an alternative treatment for drug intolerance. Combination therapy with LQSNY and drugs or other lasers may have pleasantly surprising efficacy, but numerous studies are still needed to verify this.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of low‐fluence 1064 nm Q‐switched Nd: YAG laser for the treatment of melasma: A meta‐analysis and systematic review

Chen

Peng

et al. 2022

J of Cosmetic Dermatology

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“…A recent meta-analysis of randomised controlled trials assessing the use of oral tranexamic acid for adult melasma showed significant efficacy and safety. 19 Physicians should educate themselves and the patient regarding dosage, side effects and precautions before prescribing oral tranexamic acid. Topical use has not been found to be entirely effective.…”

Section: Treatmentmentioning

confidence: 99%

Melasma

Doolan¹,

Gupta²

2021

Aust J Gen Pract

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“…Melasma is an acquired hyperpigmentary disorder emerging most commonly as symmetric patches and macules on the areas of face and neck exposed to sun. 1 In fact, melasma is considered a cosmetic disfigurement that can adversely influence the quality of life. 2 Melasma can differ in severity as there are differences in the intensity of pigmentation and area of involvement.…”

Section: Introductionmentioning

confidence: 99%

Tranexamic acid microinjections versus tranexamic acid mesoneedling in the treatment of facial melasma: A randomized assessor‐blind split‐face controlled trial

Poostiyan

Alizadeh

Shahmoradi

et al. 2023

J of Cosmetic Dermatology

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Background: Melasma is a hyperpigmentary disorder causing cosmetic disfigurement.We aimed to compare the efficacy and safety of tranexamic acid (TXA) microinjections with TXA mesoneedling for facial melasma.Methods: This randomized assessor-blind split-face controlled trial included patients with symmetric facial melasma. One side of the face received TXA (100 mg/ml) mesoneedling and the other side intradermal TXA microinjections. The interventions were repeated three times with 4-week intervals (weeks 0, 4, and 8). The primary outcome was improvement in modified Melasma Area and Severity Index (mMASI) 4 weeks after the final treatment session. Secondary outcomes were complications and patient satisfaction with the treatments evaluated by a visual analog scale (VAS).Results: All 27 patients included in the study were female (mean age: 44.22 ± 8.39 years).Both groups were comparable in terms of mMASI scores before and after treatment (standardized mean difference [SMD] = 0.32, 95% confidence interval [CI] −0.22; 0.85, p = 0.248 and SMD = −0.13, 95% CI −0.66; 0.40, p = 0.633, respectively). The mMASI score change from baseline was not different (SMD = −0.39, 95% CI −0.93; 0.15, p = 0.157). However, patient satisfaction was significantly higher with TXA mesoneedling (SMD = 0.77, 95% CI 0.21; 1.32, p = 0.007). Post-inflammatory hyperpigmentation occurred in one patient in the TXA mesoneedling group. Erythema, scaling, and edema were significantly higher with TXA mesoneedling (p < 0.001).Conclusions: TXA mesoneedling was comparable with TXA microinjection in the treatment of facial melasma, while patient satisfaction was significantly higher with TXA mesoneedling; however, the high frequency of complications occurring with this treatment should be taken into account.

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Efficacy and safety of tranexamic acid in the treatment of adult melasma: An updated meta‐analysis of randomized controlled trials

Cited by 25 publications

References 50 publications

Efficacy of low‐fluence 1064 nm Q‐switched Nd: YAG laser for the treatment of melasma: A meta‐analysis and systematic review

Efficacy of low‐fluence 1064 nm Q‐switched Nd: YAG laser for the treatment of melasma: A meta‐analysis and systematic review

Melasma

Tranexamic acid microinjections versus tranexamic acid mesoneedling in the treatment of facial melasma: A randomized assessor‐blind split‐face controlled trial

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