Complex application of СО₂ laser and tranexamic acid in the treatment of melasma in postmenopausal women (literature review)

Melasma is a common acquired pigmentation disorder, represented by patches of light brown or brown color localized on areas of the skin exposed to prolonged sunlight. The increased activity of melanocytes, which underlies the pathogenesis of melasma, is due to genetic predisposition, chronic insolation and hormonal imbalance. In postmenopausal women, the increased severity of melasma is associated with a combination of these factors. In addition, pigmentation disorders may be affected by taking certain medications and other environmental factors. There are many methods of treating melasma, including the use of topical remedies, chemical peels, laser therapy and others. In recent years, more and more attention has been paid to an integrated approach that combines various treatment methods to achieve the best result. One of the effective methods of treating this pathology is the use of a CO₂ laser. However, many patients relapse after laser treatment. In this regard, there has been interest in the combined use of laser therapy using topical agents that reduce the severity of pigmentation. One of these drugs is tranexamic acid, which has the property of reducing the activity of melanocytes.

The purpose of this literature review is to study the latest publications on the treatment of melasma using laser-associated administration of tranexamic acid.

Material and methods. The literature data on search words – melasma, hyperpigmentation, tranexamic acid, CO₂ laser, fractional grinding, laser-associated administration, postmenopause in computer databases PubMed, Elibrary, Cochrane Library, Medscape were studied. Web of Science, Scopus. Publications included basic scientific research, randomized controlled trials, comments and reviews. The results of clinical improvement were assessed by the MASI melasma area and severity index, as well as the modified mMASI index.

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