Evidence map›Paper›PMID 40776769›Full record

Trial reportJournal of cosmetic dermatology2025

Efficacy of Non-Ablative Fractional Laser Combined With Tranexamic Acid in Melasma Treatment: A Randomized Split-Face Trial.

Amirhossein Rahimnia, Motahareh Hosnian, Amir Houshang Ehsani, Pedram Nourmohammadpour, Zahra Shadlou, Mina Koohian Mohammadabadi, Ala Ehsani

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of cosmetic dermatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Amirhossein RahimniaDepartment of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.ORCID https://orcid.org/0000-0002-4451-4930
Motahareh HosnianSchool of Medicine, Tehran University of Medical Sciences, Tehran, Iran.ORCID https://orcid.org/0000-0001-8160-3564
Amir Houshang EhsaniDepartment of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.ORCID https://orcid.org/0000-0002-5483-1163
Pedram NourmohammadpourDepartment of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.ORCID https://orcid.org/0000-0003-2503-2968
Zahra ShadlouDepartment of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mina Koohian MohammadabadiSchool of Medicine, Iran University of Medical Sciences, Tehran, Iran.ORCID https://orcid.org/0000-0002-0885-4604
Ala EhsaniSkin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.ORCID https://orcid.org/0009-0003-4610-3873

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe non-ablative fractionated erbium glass laser (NAFL) 1540 nm 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.

methodsA randomized controlled trial with a split-face 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-week 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-MASI), physician global assessment (PGA), and participant satisfaction at the end of treatment, and at one and 3 months after the final laser session.

resultsBoth facial sides showed significant m-MASI score improvement at the end of treatment (p < 0.001); however, a significant recurrence was noted in both groups during follow-up. The reduction in m-MASI scores was significantly greater for the NAFL plus TXA group than for TXA alone at the end of treatment (p = 0.029). However, no significant difference was observed between the groups at the 1- and 3-month follow-ups (p = 0.33 and 0.31, respectively). NAFL plus TXA led to significantly better PGA scores at Week 12 (p < 0.001), but this improvement was not sustained during follow-up (p = 0.06 and 0.07, respectively). Participant satisfaction was consistently higher in the NAFL plus TXA group (p = 0.001).

conclusionsThe combination of NAFL and topical TXA provides significant short-term 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-term maintenance strategies.

Indexed as

Antifibrinolytic AgentsLasers, Solid-StateMelanosisTranexamic AcidAdministration, CutaneousAdultCombined Modality TherapyFemaleFollow-Up StudiesHumansMaleMiddle AgedPatient SatisfactionRecurrenceSeverity of Illness IndexTreatment OutcomeAntifibrinolytic AgentsTranexamic Aciderbium: YAG laserfractional photothermolysismelasmanon‐ablative laserstopical therapy

Identifiers

PMID40776769
PMCPMC12332518

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.