Qu Yan, Wang Fengjuan, Liu Junru, Xia Xiujuan
Department of Dermatology, Yantai Yuhuangding Hospital, The Affiliated Hospital of Qingdao University, Yantai, Shandong, China.
Dongying District People's Hospital of Dongying City, Dongying, China.
J Cosmet Dermatol. 2021 Apr;20(4):1110-1116. doi: 10.1111/jocd.13992. Epub 2021 Feb 22.
Melasma is an acquired refractory pigmentary disorder, which is a skin disease that predominantly affects females. This investigation aims to assess the efficacy of a low-power fractional CO laser combined with tranexamic acid (TXA) for melasma topical treatment with MASI and dermoscopy.
A randomized comparative split-face study was performed. Each treatment interval was 3 weeks with four times in total. At the same time, we applied TXA solution twice a day. Assessments were made by the MASI score of the melasma area severity index, and the dermoscopy performance was collected and analyzed.
After treatments, the patient MASI score decreased significantly. Compared with the baseline, the MASI score was significantly lower than that of control group (P < .05), and the decrease ratio was higher than that of controls. Dermoscopy examination results verified that all lesions performed reticuloglobular pattern, granular, or punctate, with no structural pigmentation and obvious capillary dilation. After comprehensive treatments, the pigmentation area displayed lighter chroma, the follicle pore uniformity was completely improved, and the capillary dilation was significantly reduced.
Low-power fractional CO laser combined with topical TXA solution is a comparatively effective and safe method for melasma treatment. TXA could reduce the dilation of blood vessels.
黄褐斑是一种后天性难治性色素沉着紊乱疾病，主要影响女性的皮肤疾病。本研究旨在评估低能量分数CO2激光联合氨甲环酸（TXA）外用治疗黄褐斑的疗效，采用黄褐斑面积和严重程度指数（MASI）及皮肤镜检查进行评估。
进行一项随机对照半脸研究。每次治疗间隔为3周，共进行4次。同时，每天外用TXA溶液2次。通过黄褐斑面积严重程度指数的MASI评分进行评估，并收集和分析皮肤镜表现。
治疗后，患者的MASI评分显著降低。与基线相比，MASI评分显著低于对照组（P < 0.05），降低率高于对照组。皮肤镜检查结果证实，所有皮损均表现为网状球状、颗粒状或点状，无结构色素沉着和明显的毛细血管扩张。综合治疗后，色素沉着区域色度变浅，毛囊孔均匀度完全改善，毛细血管扩张明显减轻。
低能量分数CO2激光联合外用TXA溶液是一种治疗黄褐斑相对有效且安全的方法。TXA可减少血管扩张。
