Background: Topical tranexamic acid has been used to treat melasma and as a skin whitener.
Objective: The aim of this study was to compare the skin histology and permeation of tranexamic acid after fractional and conventional CO2 laser pretreatment.
Methods: The effect of treatment with different strengths of fractional and conventional CO2 laser treatment was examined by scanning and transmission electron microscopy. Permeation of tranexamic acid through porcine skin was tested in vitro using a Franz diffusion chamber.
Results: Four passes of fractional laser treatment caused less skin damage than conventional laser treatment at the same fluency. Fractional laser treatment caused at least 85% of the cumulative tranexamic aid permeation at the same fluency, and as fluency increased, the number of passes needed to achieve this goal decreased.
Conclusion: Fractional laser treatment is as effective as conventional laser treatment in enhancing tranexamic acid delivery and causes less skin damage.