{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T01:24:56Z","timestamp":1787793896405,"version":"build-2784847793"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"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":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Melasma is a common hyperpigmentation disorder. This study aimed to compare the efficacy of Nd\u2010Yag fractional 1064 plus microinjection of tranexamic acid versus Nd\u2010Yag fractional 1064 plus oral tranexamic acid in patients with melasma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>This is a prospective, randomized study with a sample size of 40 patients, 20 in each treatment arm, which was done six times with 2\u2010week intervals. Twenty patients were administered localized microinjections (4\u00a0mg\/ml) of tranexamic acid and Q\u2010switched 1064 laser every 2\u00a0weeks in one arm, while in the other arm, 20 were given oral tranexamic acid 250\u00a0mg three times a day and Q\u2010switched 1064 laser every 2\u00a0weeks per visit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010one patients with mean SD 40.52+\u20104.95\u00a0y\/o were treated with oral tranexamic acid, and 20 patients with 43.3+\u20105.87\u00a0y\/o treated with microinjection of tranexamic acid were analyzed. There was no statistically significant difference between the two groups in terms of demographic and clinical characteristics at the baseline (<jats:italic>p<\/jats:italic>\u00a0&gt;\u00a00.05). The patients MASI score and \u2206E decrease over the study period in both treatments significantly (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). However, patient's MASI score (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.99) and \u2206E (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.53) did not differ significant between the two group over the time. Satisfaction (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.41) and complication during the study period (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.09) were not significantly different between the two group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combination treatment method can be a viable option for Middle Eastern patients having melasma disorder, and tranexamic acid appears to be an effective and safe treatment for melasma, irrespective of its route of administration. Tranexamic acid can increase the permeability locally by non\u2010invasive methods such as microneedling which is less painful than microinjection and can also increase patient satisfaction.<\/jats:p><jats:p>Although the oral method is more tolerable for the patient, it may have systemic side effects, and its combination with Q\u2010switch laser increases its effect regardless of the type of prescription. Therefore, it is recommended to use of this drug topically (cream or lotion) by non\u2010invasive methods like microneedling to reduce pain and laser treatment in future studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.14496","type":"journal-article","created":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T17:43:11Z","timestamp":1635788591000},"page":"279-289","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Comparison of efficacy and safety of tranexamic acid mesotherapy versus oral tranexamic acid in patients with melasma undergoing Q\u2010switched fractional 1064\u2010nm Nd:YAG laser: A blinded RCT and follow\u2010up"],"prefix":"10.1111","volume":"21","author":[{"given":"Elham","family":"Behrangi","sequence":"first","affiliation":[{"name":"Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC) School of Medicine Iran University of Medical Sciences (IUMS) 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University of Medical Sciences (IUMS) Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Dilmaghani","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC) School of Medicine Iran University of Medical Sciences (IUMS) Tehran 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