Comparative Efficacy of Fractional CO2 Laser and Q-Switched Nd:YAG Laser in Combination Therapy with Tranexamic Acid in Refractory Melasma: Results of a Prospective Clinical Trial

Melasma manifests as hyperpigmented macules and patches, usually affecting the face, neck, rarely upper limbs. This study evaluated comparative efficacy of a fractional CO2 laser with Q-Switched Nd:YAG in combination therapy tranexamic acid refractory melasma. A total 30 patients melasma were included this study. The (power: w, pulse energy: mJ, tip type: 300, rate: 100/cm2) was used on one side patients’ face three passes (QSNY) (Wavelength: 1064 nm, 750 fluence: 1.50 J/cm2, spot size: 4 mm × mm, hand piece: fractional) opposite same patient’s for six sessions. During course therapy, all received oral 250 mg twice daily. area severity index (MASI) score physician’s satisfaction analyzed. Thirty (mean age 39.97) included. Patient global assessment (PtGA) group significantly better than at 4th, 8th 12th weeks (p-value < 0.001). According to PtGA, improvement significant both groups over time. Physician (PGA) weeks, physician (PS) week, 0.05). PGA reduced MASI decreased more time (p most common effects reported erythema discomfort, which subsided less 24 h. is an effective well tolerated therapeutic method treatment