The influence of combined CO₂ laser therapy and tranexamic acid on the quality of life of patients with melasma: a comparative study using the mekasqol scale

Melasma is a chronic acquired skin condition (melanodermia) characterized by the formation of pigmented spots on the face, predominantly in the forehead, cheeks, and upper lip areas. This condition can have a significant negative impact on the psychosocial well‑being and quality of life of patients. Therefore, effective treatment methods and an evaluation of their impact on quality of life are necessary.
Objective of the study. To compare the effectiveness and safety of combined CO2‑laser therapy and topical tranexamic acid solution with CO2-laser monotherapy in improving the quality of life of patients with melasma, assessed using the MELASQoL scale.
Materials and methods. The study included 40 patients with clinical manifestations of melasma on the face. Half of the participants (main group) underwent 3 combined fractional photothermolysis procedures using a CO2‑laser (10600 nm), followed by the application of a 5% tranexamic acid solution with a 4‑week interval. The other half (control group) received monotherapy with only the CO2‑laser at the same intervals. Two indices were used to assess therapeutic dynamics: the Melasma Area and Severity Index (MASI) and the Melasma Quality of Life scale (MELASQoL).
Conclusions. Combined therapy with fractional CO2‑laser and tranexamic acid is superior to laser monotherapy in improving the quality of life of patients with melasma, as confirmed by a significant reduction in MELASQoL scores. The assessment of quality of life using MELASQoL is an important tool for the comprehensive evaluation of melasma treatment effectiveness.

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