BC05 Efficacy and safety of 755-nm picosecond alexandrite laser with topical tranexamic acid vs. laser monotherapy for melasma and facial rejuvenation: a multicentre, randomized, double-blinded, split-face study

Abstract The aim of this study was to compare the efficacy and safety of 755-nm picosecond alexandrite laser and topical tranexamic acid (TTA) combination therapy vs. laser monotherapy, for the treatment of melasma and facial rejuvenation. This multicentre, randomized, double-blinded, split-face study enrolled 37 patients who presented with melasma and photoageing. Facial halves were randomized to receive either laser and TTA combination therapy or laser monotherapy. Three treatments were delivered at 4–5-week intervals. Patients were followed up at 1, 3 and 6 months after the final treatment and were evaluated by blinded investigators for hemi-Melasma Area and Severity Index (hemi-MASI), facial dyschromia, skin texture, laxity and rhytids. Daily diaries rating the healing progress for 7 days post-treatment and satisfaction grading were completed by all patients. Adverse events were recorded. Thirty-six patients completed the follow-up. Compared with baseline, hemi-MASI, dyschromia and skin texture on both halves improved significantly throughout the follow-up (P < 0.001). Significant differences in hemi-MASI and dyschromia between the halves receiving combination therapy and monotherapy were noticed at 1 month and 3 months (P < 0.05). The laser monotherapy halves displayed significantly less redness and sensitivity during the 7-day post-treatment recovery period (P < 0.05). Patients’ satisfaction ratings for the combination therapy halves were higher than for monotherapy at the 1-month follow-up (P < 0.05). No severe adverse events were observed. The picosecond alexandrite laser and TTA combination therapy demonstrated synergistic efficacy for improvements in hemi-MASI and dyschromia over laser monotherapy. Optimization of the picosecond laser and TTA combination regimen needs further investigation.