{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T04:03:34Z","timestamp":1784952214644,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T00:00:00Z","timestamp":1605052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Melasma can be associated with immense psychosocial stress, which can impact quality of life. One theory suggests that ultraviolet light can increase plasmin activity in keratinocytes, which has led to the investigation of tranexamic acid for treating melasma, since it possesses anti\u2010plasmin properties. The use of laser\u2010assisted drug delivery can also increase the uptake of topical medications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>A prospective pilot study was performed to assess the utility of combination treatment with low\u2010energy, low\u2010density 1927\u00a0nm fractional thulium fiber laser and topical tranexamic acid for melasma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/Methods<\/jats:title><jats:p>A total of 10 subjects were enrolled. Each received 5 treatments to the full face with a low\u2010energy, low\u2010density 1927\u00a0nm fractional thulium fiber laser. Immediately following treatment, topical tranexamic acid was applied, and subjects were instructed to apply it twice daily for 7\u00a0days. Clinical measures, quality of life, and patient satisfaction were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean improvements in Melasma Area and Severity Index (MASI) scores were 1.1 (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0899), 3.5 (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0395), and 2.5 (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.2429) at 30\u2010, 90\u2010, and 180\u2010day follow\u2010up, respectively. Maximum improvement occurred at 90\u2010day follow\u2010up. The mean improvement of Melasma Quality of Life Scale (MELASQOL) score was 9.6 (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0024) at 30\u2010day follow\u2010up. In addition to changes in pigmentation, subjects also believed their skin felt better, looked more radiant, and had improvements in skin texture and tone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Combination of low\u2010energy, low\u2010density 1927\u00a0nm fractional thulium fiber laser and topical tranexamic acid improved clinical outcomes and quality of life associated with melasma. This combination treatment was safe, well\u2010tolerated, and well\u2010liked by subjects.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.13817","type":"journal-article","created":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T10:46:14Z","timestamp":1605091574000},"page":"105-109","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Laser\u2010assisted delivery of tranexamic acid for melasma: Pilot study using a novel 1927\u00a0nm fractional thulium fiber laser"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7437-2745","authenticated-orcid":false,"given":"Jordan V.","family":"Wang","sequence":"first","affiliation":[{"name":"Laser &amp; Skin Surgery Center of New York  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitalee P.","family":"Christman","sequence":"additional","affiliation":[{"name":"Laser &amp; Skin Surgery Center of New York  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Feng","sequence":"additional","affiliation":[{"name":"Laser &amp; Skin Surgery Center of New York  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina","family":"Ferzli","sequence":"additional","affiliation":[{"name":"Laser &amp; Skin Surgery Center of New York  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Jeon","sequence":"additional","affiliation":[{"name":"Laser &amp; Skin Surgery Center of New York  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy G.","family":"Geronemus","sequence":"additional","affiliation":[{"name":"Laser &amp; Skin Surgery Center of New York  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/dth.12465"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2003.05419.x"},{"issue":"8","key":"e_1_2_10_4_1","first-page":"E73","article-title":"Tranexamic acid for melasma: evaluating the various formulations","volume":"12","author":"Wang JV","year":"2019","journal-title":"J Clin Aesthet Dermatol"},{"issue":"5","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1111\/jocd.12830","article-title":"Evaluation of oral tranexamic acid in the treatment of melasma","volume":"18","author":"Colferai MMT","year":"2018","journal-title":"J Cosmet 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harvesting system","volume":"18","author":"Waibel JS","year":"2019","journal-title":"J Drugs Dermatol"},{"issue":"6","key":"e_1_2_10_14_1","first-page":"624","article-title":"Treatment of atrophic scars with fractionated CO2 laser facilitating delivery of topically applied poly\u2010L\u2010lactic acid","volume":"40","author":"Rkein A","year":"2014","journal-title":"Dermatol Surg"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","DOI":"10.1007\/s10103-020-03045-8","article-title":"The efficacy in treatment of facial melasma with thulium 1927\u2010nm fractional laser\u2010assisted topical tranexamic acid delivery: a split\u2010face, double\u2010blind, randomized controlled pilot study","author":"Wanitphakdeedecha R","year":"2020","journal-title":"Lasers Med Sci"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.12474"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.5978\/islsm.27_18-OR-26"}],"container-title":["Journal of Cosmetic 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