Effectiveness of laser and topical tranexamic acid combination therapy in melasma: An updated systematic review and meta-analysis of randomized controlled trials.

Autor: Khan QA; Khyber Teaching Hospital MTI KTH, Peshawar, Pakistan., Abdi P; Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada., Farkouh C; Rush Medical College, 1035 West Van Buren Street, Chicago, IL, 60607, USA. christopher_s_farkouh@rush.edu., Anthony MR; University of Arizona College of Medicine, Tucson, AZ, USA., Chundru A; Ross University School of Medicine, Bridgetown, Barbados., Amatul F; Mercer University School of Medicine, Macon, GA, USA., Parimi K; Vydehi Institute of Medical Sciences and Research Center, Bangalore, India., Santiago N; Universidad Autónoma de Guadalajara, Guadalajara, Mexico., Farkouh M; Ponce Health Sciences University, Ponce, Puerto Rico, USA., Iram S; Sultan Qaboos University, Muscat, Oman., Khan A; Khyber Teaching Hospital MTI KTH, Peshawar, Pakistan.
Jazyk: angličtina
Zdroj: Lasers in medical science [Lasers Med Sci] 2023 Jun 16; Vol. 38 (1), pp. 139. Date of Electronic Publication: 2023 Jun 16.
DOI: 10.1007/s10103-023-03810-5
Abstrakt: Melasma is a chronic relapsing skin condition. Laser therapy is a new advancement in treatment. Whether the topical application of tranexamic acid (TXA) increases the efficacy of laser therapy in melasma is still under debate. With recent studies yielding different results, it was imperative to compile all the available literature systematically. This meta-analysis investigates the effectiveness of a combination therapy of laser plus TXA acid for treating melasma. PubMed/MEDLINE, Cochrane Central, Google Scholar, Scopus, and the International Clinical Trials registry were systematically searched for article retrieval. Screening per PRISMA guidelines was undertaken by two independent reviewers using the Covidance database. Melasma area of severity index (MASI)/modified MASI was used as the clinical improvement outcomes. A total of nine studies that described the combined use of topical tranexamic acid with laser therapy were included for meta-analysis. These studies employed various types of lasers along with topical TXA. The results showed that the combination of both laser therapy and topical TXA significantly decreased the MASI score (P < 0.0001). Subgroup analyses revealed that fractional CO 2 laser among the laser types and monthly laser plus twice daily topical TXA were most effective in decreasing the MASI/mMASI score. The meta-analysis found that combining topical tranexamic acid and laser therapy is an effective and safer treatment option for treatment-resistant melasma. Furthermore, monthly fractional CO 2 laser and daily application of topical tranexamic acid showed high effectiveness and safety.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)
Databáze: MEDLINE
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