{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T09:53:56Z","timestamp":1784368436925,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The non\u2010ablative fractionated erbium glass laser (NAFL) 1540\u2009nm combined with topical tranexamic acid (TXA) is a novel therapeutic approach for melasma. However, the efficacy and safety of this combination remain controversial. This study aims to evaluate the effectiveness and safety of NAFL combined with TXA in treating melasma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A randomized controlled trial with a split\u2010face design was conducted on 27 participants with symmetric melasma. All participants applied 5% TXA topically twice daily to their entire face. One side of the face underwent three NAFL sessions combined with TXA at 4\u2010week intervals, while the opposite side, treated with TXA alone, served as the control. Outcomes were assessed using the modified melasma area and severity index (m\u2010MASI), physician global assessment (PGA), and participant satisfaction at the end of treatment, and at one and 3\u2009months after the final laser session.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both facial sides showed significant m\u2010MASI score improvement at the end of treatment (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001); however, a significant recurrence was noted in both groups during follow\u2010up. The reduction in m\u2010MASI scores was significantly greater for the NAFL plus TXA group than for TXA alone at the end of treatment (<jats:italic>p<\/jats:italic>\u2009=\u20090.029). However, no significant difference was observed between the groups at the 1\u2010 and 3\u2010month follow\u2010ups (<jats:italic>p<\/jats:italic>\u2009=\u20090.33 and 0.31, respectively). NAFL plus TXA led to significantly better PGA scores at Week 12 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), but this improvement was not sustained during follow\u2010up (<jats:italic>p<\/jats:italic>\u2009=\u20090.06 and 0.07, respectively). Participant satisfaction was consistently higher in the NAFL plus TXA group (<jats:italic>p<\/jats:italic>\u2009=\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The combination of NAFL and topical TXA provides significant short\u2010term clinical benefits in treating melasma, likely by enhancing TXA penetration into target tissues and improving pigmentary clearance. However, its efficacy diminishes over time due to the inevitable recurrence of melasma, necessitating further investigation into long\u2010term maintenance strategies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.70384","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T07:48:24Z","timestamp":1754639304000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy of Non\u2010Ablative Fractional Laser Combined With Tranexamic Acid in Melasma Treatment: A Randomized Split\u2010Face Trial"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4451-4930","authenticated-orcid":false,"given":"Amirhossein","family":"Rahimnia","sequence":"first","affiliation":[{"name":"Department of Dermatology, Razi Hospital Tehran University of Medical Sciences  Tehran Iran"},{"name":"Autoimmune Bullous Diseases Research Center, Razi Hospital Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8160-3564","authenticated-orcid":false,"given":"Motahareh","family":"Hosnian","sequence":"additional","affiliation":[{"name":"School of Medicine Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5483-1163","authenticated-orcid":false,"given":"Amir houshang","family":"Ehsani","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Razi Hospital Tehran University of Medical Sciences  Tehran Iran"},{"name":"Autoimmune Bullous Diseases Research Center, Razi Hospital Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2503-2968","authenticated-orcid":false,"given":"Pedram","family":"Nourmohammadpour","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Razi Hospital Tehran University of Medical Sciences  Tehran Iran"},{"name":"Autoimmune Bullous Diseases Research Center, Razi Hospital Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Shadlou","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Razi Hospital Tehran University of Medical Sciences  Tehran Iran"},{"name":"Autoimmune Bullous Diseases Research Center, Razi Hospital Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0885-4604","authenticated-orcid":false,"given":"Mina","family":"Koohian Mohammadabadi","sequence":"additional","affiliation":[{"name":"School of Medicine Iran University of Medical Sciences  Tehran 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