KTP Laser vs. Tranexamic Acid Injections for Facial Ephelides

Woman in sun with freckles
QS-KTP laser proves effective in treating facial ephelides

To compare the efficacy and safety of intradermal injection of tranexamic acid (TXA) with a Q-switched KTP laser (532 nm) in the treatment of facial ephelides, researchers performed a randomized, comparative, split-face study. The results of this study were published in the Jounral of Lasers in Surgery and Medicine (March 2021). 

The study included 30 female subjects with bilateral facial ephelides. One cheek was treated with intra-dermal TXA injections and the other with QS-KTP laser. Researchers assessed outcomes through the use of photography, pigmentation area, severity index and spectrophotometry at baseline, one week and two months after treatment. 

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There was a significant difference between the sides in percentage change of pigmentation area, severity score (PSI) and melanin index (MI) after treatment and during the follow up. PSI decreased by 66.5% and 15.4% (laser and TXA sides, respectively) at two weeks. A further decrease was noted at two months (69.4% with laser and 26.1% with TXA). MI also improved from 7.7% to 3.1% after KTP laser and from 6.5% to 2.4% after TXA injections. Four subjects developed post-inflammatory hyperpigmentation (PIH) following treatment with the QS-KTP laser. 

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