Efficacy and Safety of Combination Therapy of Intense Pulsed Light and Topical Tranexamic Acid in the Treatment of Melasma

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Background: Melasma is a chronic hypermelanosis requiring effective therapies. Methods: This prospective, randomized controlled trial evaluated intense pulsed light (IPL) and topical tranexamic acid (TXA) versus IPL with placebo. Thirty-three patients completed the 5-month study (group A: TXA + IPL, n = 17; group B: Placebo + IPL, n = 16). Outcome included VISIA analysis, modified Melasma Area and Severity Index (mMASI), skin melanin index (MI) and erythema index (EI) measurement. Results: At Month 5, both groups showed improved mMASI scores; however, group A demonstrated a significantly greater reduction than group B (−50.52% vs. −38.49%; mean difference −12.03%, 95% CI −23.74% to −0.32%; p < 0.05). Excellent improvement was achieved in 70.59% of Group A versus 25% of Group B. Furthermore, Group A exhibited a significant decrease in MI (−36.31%) compared to a negligible change in Group B (−1.28%), with a significant between-group difference (p = 0.02). VISIA analysis confirmed superior improvements in brown spots and texture for Group A (p < 0.05). No adverse events occurred. Conclusions: Combining topical TXA with IPL is a safe and significantly more effective treatment for melasma than IPL alone, offering superior pigment reduction without increased risks.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.