Efficacy and Safety of Topical Tranexamic Acid Alone or in Combination with Either Fractional Carbon Dioxide Laser or Microneedling for the Treatment of Melasma.

Introduction: Tranexamic acid (TXA) is a promising treatment modality for melasma. Microneedling (MN) and fractional carbon dioxide (CO) laser were reported to enhance TXA transepidermal delivery.

Objectives: To compare efficacy and safety of topical TXA alone or in combination with either fractional CO laser or MN for treatment of melasma.