---
title: "Effectiveness of laser and topical tranexamic acid combination…"
description: "Combining laser therapy with topical tranexamic acid is an effective treatment for melasma, with fractional CO2 laser and daily TXA showing the best…"
url: "https://magellanlongevity.com/study/d37326860.md"
canonical: "https://magellanlongevity.com/study/d37326860.html"
html: "https://magellanlongevity.com/study/d37326860.html"
type: "study"
study_key: "d37326860"
journal: "Lasers Med Sci"
year: 2023
pmid: "37326860"
doi: "10.1007/s10103-023-03810-5"
citations: 1
updated: 2026-09-02
author: "Gabriel Radu, DO"
author_credentials: "Physiatrist (PM&R). NY medical license 275110. NPI 1376861765."
publisher: "Magellan Longevity"
content_format: "markdown"
---

# Effectiveness of laser and topical tranexamic acid combination therapy in melasma: a meta-analysis

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## Citation

| Field | Value |
| --- | --- |
| Journal | Lasers Med Sci |
| Year | 2023 |
| PMID | [37326860](https://pubmed.ncbi.nlm.nih.gov/37326860/) |
| DOI | [10.1007/s10103-023-03810-5](https://doi.org/10.1007/s10103-023-03810-5) |
| Study key | d37326860 |

## Takeaway

Combining laser therapy with topical tranexamic acid is an effective treatment for melasma, with fractional CO2 laser and daily TXA showing the best results.

## The question

Does the topical application of tranexamic acid (TXA) increase the efficacy of laser therapy in treating melasma?

## Hypothesis

The combination of laser therapy and topical tranexamic acid will be more effective in treating melasma compared to laser therapy alone.

## Methods

A meta-analysis was conducted by systematically searching PubMed/MEDLINE, Cochrane Central, Google Scholar, Scopus, and the International Clinical Trials registry. Two independent reviewers screened articles using the Covidance database per PRISMA guidelines. Clinical improvement was measured using the Melasma Area of Severity Index (MASI) or modified MASI (mMASI). Nine studies describing the combined use of topical tranexamic acid with various laser therapies were included.

## Results

The combination of laser therapy and topical TXA significantly decreased the MASI score (P < 0.0001). Subgroup analyses indicated that fractional CO2 laser was the most effective laser type, and a regimen of monthly laser plus twice daily topical TXA was most effective in decreasing MASI/mMASI scores.

## Conclusion

Combining topical tranexamic acid and laser therapy is an effective and safer treatment option for treatment-resistant melasma. Specifically, monthly fractional CO2 laser combined with daily topical tranexamic acid showed high effectiveness and safety.

## Limitations

The abstract does not explicitly state any limitations of the meta-analysis itself, such as heterogeneity among studies or publication bias.

## Verbatim from the abstract

> combining topical tranexamic acid and laser therapy is an effective and safer treatment for melasma

## Where this study is used on Magellan

This paper is one of the citations behind the evidence grade on the pages below. Grades are assigned from the published research and are independent of affiliate commissions.

| Compound or device | Evidence grade | Graded pages |
| --- | --- | --- |
| Topical Tranexamic Acid Serum | Moderate evidence | [Topical Tranexamic Acid Serum](https://magellanlongevity.com/p/195.md) |

## Reference

1. **Effectiveness of laser and topical tranexamic acid combination therapy in melasma: a meta-analysis**
   Lasers Med Sci 2023 · [PMID 37326860](https://pubmed.ncbi.nlm.nih.gov/37326860/) · [DOI 10.1007/s10103-023-03810-5](https://doi.org/10.1007/s10103-023-03810-5)

   > combining topical tranexamic acid and laser therapy is an effective and safer treatment for melasma

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## Related on Magellan Longevity

- [Topical Tranexamic Acid Serum](https://magellanlongevity.com/p/195.md) — product graded on this and related evidence
- [Evidence: inhibits plasmin, reduces melanin](https://magellanlongevity.com/study/s195.md)
- [Comparative efficacy and safety of tranexamic acid for melasma by different…](https://magellanlongevity.com/study/d38059683.md)
- [Longevity research map](https://magellanlongevity.com/longevity-research-map.html)
- [Evidence-based longevity supplements](https://magellanlongevity.com/longevity-supplements.md)

## Scope and disclosures

Educational information, not medical advice. Nothing here is intended to diagnose, treat, cure, or prevent any disease. Talk to your physician before starting any supplement or device, especially if you are pregnant, nursing, or taking medication.

Editorial firewall: evidence grades are assigned from the published research and are independent of any affiliate commission. As an Amazon Associate, Magellan Longevity earns from qualifying purchases.

Reviewed for accuracy by a board-certified physician (DO).