Clinical study on the efficacy of tranexamic acid combined with narrowband intense pulsed light for the treatment of melasma

[Objective] To investigate the efficacy and patients' satisfaction of combing narrowband intense pulsed light (DPL) with tranexamic acid for the treatment of facial melasma. [Methods] Ninety melasma patients treated at Gaoyou People's Hospital between November 2022 and August 2024 were randomly divided into three groups (30 patients per group). The medication group received oral tranexamic acid tablets (0.25 g twice daily for 6 months), while the DPL group underwent DPL treatment once per month for 4 sessions. The combination group received both interventions following the same protocols as the other two groups. The melasma area and severity index (MASI) scores were compared before and after the treatment. The efficacy and patients' satisfaction were evaluated after the treatment. Adverse reactions and recurrence rates were also monitored. [Results] After the treatment, the combination group achieved a greater reduction in MASI scores than the other two groups (62.20±19.14% vs. 48.10±22.18% in the DPL group and 45.32±20.74% in the medication group, P<0.05). Moreover, both total effective rate and patients' satisfaction scores were higher in the combination group than the other groups (80.00% vs. 53.33% in the DPL group and 50.00% in medication group, P<0.05). No significant adverse reactions were observed across groups. At six-month follow-up, no recurrence was observed in the combination group, while 2 cases were reported in the DPL group and 1 case in the medication group. [Conclusion] The combination of DPL and tranexamic acid represents a safe and effective approach for the management of melasma.