Oral tranexamic acid, low-fluence intense pulsed light, and glycolic acid for the treatment of mixed melasma: An observational study.

This study aimed to compare the efficacy and safety of triple therapy with oral tranexamic acid (TA), low-fluence intense pulsed light (IPL), and glycolic acid (GA) peels versus the same regimen without GA for treating mixed melasma. Patients with mixed melasma were randomly divided into 2 groups, with 20 patients in each group. The treatment duration was 4 months. Group A received oral TA (250 mg twice daily) combined with 2 sessions of low-fluence IPL per month (at a 2-week interval). Group B was treated with TA in combination with low-fluence IPL following the same procedure and weekly alternating treatment with GA. Both groups underwent a total of 8 IPL sessions over the course of the treatment. Patients were followed monthly for 3 months. At the end of the treatment, group B showed a lower mean modified Melasma Area and Severity Index (mMASI) score (3.14 ± 1.84) compared with group A (4.11 ± 2.05). The mean percentage improvement in mMASI scores was 46.81 ± 11.1 for group A and 60.70 ± 10.9 for group B (P < .05). Both groups exhibited a significant reduction in telangiectasia. Combining low-fluence IPL and GA with oral TA resulted in better cosmetic improvement than the treatment combination without GA.