PMID- 37557109
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230812
IS  - 2160-9381 (Print)
IS  - 2160-9381 (Electronic)
IS  - 2160-9381 (Linking)
VI  - 13
IP  - 3
DP  - 2023 Jul 1
TI  - Efficacy and Safety of Topical Tranexamic Acid Alone or in Combination with 
      Either Fractional Carbon Dioxide Laser or Microneedling for the Treatment of 
      Melasma.
LID - 10.5826/dpc.1303a195 [doi]
LID - e2023195
AB  - INTRODUCTION: Tranexamic acid (TXA) is a promising treatment modality for 
      melasma. Microneedling (MN) and fractional carbon dioxide (CO(2)) laser were 
      reported to enhance TXA transepidermal delivery. OBJECTIVES: To compare efficacy 
      and safety of topical TXA alone or in combination with either fractional CO(2) 
      laser or MN for treatment of melasma. METHODS: Thirty females with facial melasma 
      were divided randomly into 3 equal groups after excluding pregnant and lactating 
      women and those using oral contraceptives or other hormonal therapy. Patients of 
      group A were treated with fractional CO(2) laser and those of group B were 
      treated with MN (4 sessions, 3 weeks apart for both) with immediate topical 
      application of TXA 5% solution after sessions and daily application of 5% TXA 
      cream for both groups. Patients of group C were treated by topical daily 
      application of TXA 5% cream. Evaluation was done by modified melasma area and 
      severity index scores (mMASI), patient satisfaction and dermoscopy. RESULTS: 
      Statistically significant improvement of mMASI was reported in all studied groups 
      with a significantly better improvement in patients of groups A and B than those 
      of group C, meanwhile the difference between groups A and B was statistically 
      insignificant. CONCLUSIONS: Topical TXA is a safe and fairly effective treatment 
      modality for facial melasma. Combining TXA with either fractional CO(2) laser or 
      MN yielded significantly better improvement than when used alone. Fractional 
      CO(2) laser carries the risk of post-inflammatory hyperpigmentation in patients 
      with skin types III and IV and requires meticulous patient selection.
FAU - Mamdouh Kamal Dawaud, Safaa
AU  - Mamdouh Kamal Dawaud S
AD  - Ministry of Health, Tanta, Egypt.
FAU - Hegab, Doaa Salah
AU  - Hegab DS
AD  - Faculty of Medicine, Dermatology and Venereology Department, Tanta University, 
      Tanta, Egypt.
FAU - Mohamed El Maghraby, Gamal
AU  - Mohamed El Maghraby G
AD  - Pharmaceutical Technology Department, Faculty of Pharmacy, Tanta University, 
      Tanta, Egypt.
FAU - Ahmad El-Ashmawy, Amal
AU  - Ahmad El-Ashmawy A
AD  - Faculty of Medicine, Dermatology and Venereology Department, Tanta University, 
      Tanta, Egypt.
LA  - eng
PT  - Journal Article
DEP - 20230701
PL  - Austria
TA  - Dermatol Pract Concept
JT  - Dermatology practical & conceptual
JID - 101585990
PMC - PMC10412040
COIS- Competing Interests: None.
EDAT- 2023/08/10 00:42
MHDA- 2023/08/10 00:43
PMCR- 2023/07/01
CRDT- 2023/08/09 18:32
PHST- 2023/03/04 00:00 [accepted]
PHST- 2023/08/10 00:43 [medline]
PHST- 2023/08/10 00:42 [pubmed]
PHST- 2023/08/09 18:32 [entrez]
PHST- 2023/07/01 00:00 [pmc-release]
AID - dpc.1303a195 [pii]
AID - dp1303a195 [pii]
AID - 10.5826/dpc.1303a195 [doi]
PST - epublish
SO  - Dermatol Pract Concept. 2023 Jul 1;13(3):e2023195. doi: 10.5826/dpc.1303a195.