title: Oral tranexamic acid enhances the efficacy of low-fluence 1064-nm quality-switched neodymium-doped yttrium aluminum garnet laser treatment for melasma in Koreans: a randomized, prospective trial.
abstract: BACKGROUND
  Tranexamic acid (TA) has recently gained in popularity in the treatment of pigmentary disorders.
  
  
  OBJECTIVE
  To evaluate the clinical efficacy and safety of oral TA combined with low-fluence 1064-nm quality-switched neodymium-doped yttrium aluminum garnet (QSNY) laser for the treatment of melasma.
  
  
  METHODS
  Forty-eight patients with melasma were enrolled in the study and subsequently divided into two groups: a combination group and a laser treatment group. All patients were treated with two sessions of low-fluence QSNY laser, and patients in the combination group took 8 weeks of oral TA. Two blinded dermatologists evaluated patients using the Modified Melasma Area and Severity Index (mMASI) and a clinical improvement scale.
  
  
  RESULTS
  Mean mMASI score 4 weeks after the second treatment decreased significantly in both groups from base line. Based on overall clinical improvement, a greater number of patients scored as grade 3 and more in the combination group; no patients were scored as grade 4 in the laser-alone group.
  
  
  CONCLUSIONS
  Oral TA may prove a safe and efficient treatment option for melasma in combination with low-fluence QSNY laser therapy.
authors.affiliation: Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, College of Medicine, Yonsei University, Seoul, Korea.
authors.forename: Jung U
authors.initials: JU
authors.lastname: Shin
authors.forename: Jihun
authors.initials: J
authors.lastname: Park
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Oh
authors.forename: Ju Hee
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000933:Antifibrinolytic Agents / Q000008:administration & dosage* / Q000494:pharmacology; D044466:Asian People; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008545:Melanoma / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000628:therapy*; D014148:Tranexamic Acid / Q000008:administration & dosage* / Q000494:pharmacology
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid