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Efficacy and safety of 755-nm picosecond alexandrite laser with topical tranexamic acid versus laser monotherapy for melasma and facial rejuvenation: a multicenter, randomized, double-blinded, split-face study in Chinese patients

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Abstract

To compare the efficacy and safety of 755-nm picosecond alexandrite laser and topical tranexamic acid (TTA) combination therapy with laser monotherapy, for the treatment of melasma and facial rejuvenation. This multicenter, randomized, double-blinded, split-face study enrolled 37 patients who presented with melasma and photoaging. Facial halves were randomized to receive either laser and TTA combination therapy or laser monotherapy. Three treatments were delivered at 4–5 weeks intervals. Patients were followed up for 1, 3, and 6 months post-final treatment and evaluated by blinded investigators for hemi-Melasma Area and Severity Index (hemi-MASI), facial dyschromia, skin texture, laxity, and rhytids. Daily diaries rating healing progress for 7 days posttreatment and satisfaction grading were performed by all patients. Adverse events were recorded. Thirty-six patients completed the follow-up. Compared with the baseline, hemi-MASI, dyschromia, and skin texture on both halves improved significantly through the follow-up (p = 0.000). A significant difference in hemi-MASI and dyschromia between combination therapy halves and monotherapy halves was noticed at 1- and 3-month follow-ups (p < 0.05). The laser monotherapy halves displayed significantly less redness and sensitivity during the 7-day posttreatment recovery period (p < 0.05). Patients’ satisfaction ratings for the combination therapy halves were higher than the monotherapy halves at 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 hemi-MASI and dyschromia improvements over laser monotherapy. The optimization of the picosecond laser and TTA combination regimen needs further investigation.

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Funding

The work was supported by the following fundings: Post-Doctor Research Project, West China Hospital, Sichuan University (No. 2020HXBH050); China Postdoctoral Science Foundation (No. 2021M692292); and National Natural Science Foundation of China (No. 82103753).

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Authors and Affiliations

  1. Department of Dermatology and Venerology, West China Hospital, Sichuan University, Sichuan Province, Chengdu, 610041, People’s Republic of China

    Yiming Li & Li Li

  2. Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, People’s Republic of China, 610041

    Yiming Li

  3. Department of Dermatology, Shanghai PhiSkin Clinic, Jingan District, 480 North Urumqi Road, Shanghai, People’s Republic of China, 200040

    Cheng Yao

  4. Department of Dermatology, Beijing PhiSkin Clinic, 8 East Tucheng Road, Chaoyang District, Beijing, People’s Republic of China, 100013

    Heye Zhang

  5. Department of Dermatology, LingQi Branch, Shanghai PhiSkin Clinic, Huangpu District, 222 Hubin Road, Shanghai, People’s Republic of China, 200021

    Yiyi Song

Authors
  1. Yiming Li
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  2. Cheng Yao
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  4. Li Li
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Contributions

Yiming Li and Yiyi Song contributed to the study’s conception and design. Cheng Yao, Heye Zhang, and Yiyi Song administered the treatment. Yiming Li and Yiyi Song collected the data. Yiming Li and Li Li assessed the clinical photographs and performed data analysis. The manuscript was drafted by Yiming Li, and all authors commented on the draft. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yiyi Song.

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Ethics approval

The study was reviewed and approved by the hospital ethics committee. The study protocol followed the guidelines of the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all the participants included in the study.

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The authors affirm that human research participants provided informed consent for the publication of the images in Fig. 1.

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The authors declare no competing interests.

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Li, Y., Yao, C., Zhang, H. et al. Efficacy and safety of 755-nm picosecond alexandrite laser with topical tranexamic acid versus laser monotherapy for melasma and facial rejuvenation: a multicenter, randomized, double-blinded, split-face study in Chinese patients. Lasers Med Sci 37, 2879–2887 (2022). https://doi.org/10.1007/s10103-022-03566-4

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  • DOI: https://doi.org/10.1007/s10103-022-03566-4

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