 METHODS: Twenty patients with melasma were included in a randomized controlled observer-blinded study with split-face design. Each side of the face was randomly allocated to either six session at two-week interval of low influence 1064 Nd:YAG laser 6 mm spot size, energy fluence 1.2 - 1.4 Jcm 2 at 10 Hz or low influence 1064nm Nd:YAG laser combined with intradermal tranexamic acid injection.Complication Improvement of melasma was assessed by Melasma area severity index MASI,physicians global assessment PhGA, MELASQOL scale, patients global assessment PGA, and patients satisfaction at baseline,6th week,10th week after first treatment and 3 months, and 6 months after last treatment. 