背景:皮秒755-nm翠绿宝石激光和局部氨甲环酸(TA)已显示出治疗黑斑病的希望。
目的:这项研究的目的是评估皮秒755nm翠绿宝石激光联合局部TA治疗黄褐斑的有效性和安全性。
方法:将48例双侧对称黄褐斑患者随机接受局部TA和皮秒激光治疗或激光单药治疗。所有患者接受连续三次皮秒激光治疗,间隔4周,另外一侧面部接受局部TA治疗,每天两次,直到第三次治疗后4周。使用改良的黄褐斑面积和严重程度指数(mMASI)评分评估疗效,VISIA(Canfield,美国)红色区域特征计数,和通过Antera3D®测量的平均孔体积。通过问卷调查评估患者的满意度。
结果:35名患者完成了研究。后处理,mMASI评分和VISIA红色区域特征计数在联合治疗一半和激光单药治疗一半中较低,和平均黑色素水平较低的联合治疗一半(p<0.05)。第三次治疗后,联合治疗一半和激光治疗一半之间的比较显示mMASI评分存在显着差异,黑色素水平,和VISIA红色区域特征计数(p<0.05)。治疗后,联合治疗一半和单药治疗一半的患者满意率分别为71.4%和54.3%,分别为(p<0.05)。在联合治疗一半中未观察到明显的不良反应;然而,10.42%(5/48)的参与者在激光单一疗法一半经历了暂时性色素沉着,在3个月内解决。
结论:皮秒755nm翠绿宝石激光,当独立使用和与外用TA组合使用时,已被证明是有效的改善黄褐斑。然而,综合治疗方法显示黄褐斑症状有更明显的改善,患者满意度更高,并且与较低的不良反应发生率相关。这些发现强烈支持将局部TA与皮秒激光治疗相结合作为黄褐斑管理的优越治疗策略。
背景:中国临床试验注册中心:ChiCTR2200057771.
BACKGROUND: The picosecond 755-nm alexandrite laser and topical tranexamic acid (TA) have shown promise in treating
melasma.
OBJECTIVE: This aim of this study was to evaluate the efficacy and safety of combining to a picosecond 755-nm alexandrite laser combined with topical TA for
melasma treatment.
METHODS: Forty-eight patients\' facial halves with bilateral symmetrical
melasma were randomized to receive either topical TA and picosecond laser treatment or laser monotherapy. All patients received three consecutive picosecond laser treatment sessions at 4-week intervals, and additional one side facial received topical TA treatment twice daily until 4 weeks after the third treatments. Efficacy was assessed using the Modified
Melasma Area and Severity Index (mMASI) score, VISIA (Canfield, USA) red area feature counts, and average pore volume as measured by Antera 3D®. Patient satisfaction was evaluated through questionnaires.
RESULTS: Thirty-five patients completed the study. Post-treatment, mMASI scores and VISIA red area feature counts were lower in combination therapy halves and laser monotherapy halves, and average melanin level was lower in the combination therapy halves (p < 0.05). Comparisons between the combination therapy halves and laser monotherapy halves after the third treatment revealed significant differences in mMASI scores, melanin levels, and VISIA red area feature counts (p < 0.05). After treatment, patient satisfaction rates in the combination therapy halves and monotherapy halves was 71.4% and 54.3%, respectively (p < 0.05). No obvious adverse effects were observed in the combination therapy halves; whereas, 10.42% (5/48) of participants in the laser monotherapy halves experienced temporary pigmentation, which resolved within 3 months.
CONCLUSIONS: The picosecond 755-nm alexandrite laser, when used independently and in combination with topical TA, has been proven to be effective in the improvement of melasma. However, the combined treatment approach showed a more pronounced improvement in
melasma symptoms, with higher patient satisfaction, and was associated with a lower incidence of adverse effects. These findings strongly support that integrating topical TA with picosecond laser therapy as a superior therapeutic strategy for melasma management.
BACKGROUND: Chinese Clinical Trial Registry: ChiCTR2200057771.