HYBRID EVENT: You can participate in person at Paris, France or Virtually from your home or work.
Nadia Ali Azfar, Speaker at Dermatology Conferences
Pakistan Association of Dermatologists, Pakistan
Title : Comparison between the efficacies of topical tranexamic acid versus intralesional tranexamic acid in treatment of melasma


 Melasma is a common acquired disorder of hyperpigmentation and its treatment often necessitates a multifaceted approach especially in refractory cases. Topical tranexamic acid is commonly used but studies claimed that intralesional injection of tranexamic acid was more efficacious. 

OBJECTIVE: To compare the efficacy of tranexamic acid intralesional (localized microinjections) versus topical therapy in the treatment of melasma.

 METHODOLOGY: This study involved 72 patients of melasma of both genders  between 20-50 years, randomly allocated into two treatment groups. Group-A was given topical TXA while Group-B was treated with intradermal injection of TXA. Efficacy was labeled as ≥50% reduction in baseline MASI score after 12 weeks of treatment.  

RESULTS: The mean age of the patients was 30.53±8.68 years. There were 13 (18.1%) male and 59 (81.9%) female patients. Majority (n=49, 68.1%) of the patients had FitzPatrick Type-V skin phototype.Moderate melasma in 47 (65.3%) patients and severe in 25 (34.7%) patients. Melasma was epidermal in 43 (59.7%) patients while dermal and mixed type was noted in 18.1% and 22.2% patient’s respectively. The frequency of efficacy was significantly higher in patients treated with intralesional TXA as compared to topical TXA (66.7% vs. 27.8%; p-value=0.001). 

CONCLUSION: Intralesional injection of tranexamic acid was found superior to conventional practice of its topical application in the management of patients with melasma regardless of patient’s age, gender, marital and educational status, skin type and type, pattern and severity of disease which along with its well established safety profile and convenience of once-weekly dosage advocate the preferred use of this novel approach in the management of such patients in future dermatologic practice.

The Audience will be able to use what they learn in patients of melasma. The risks of oral Tranexamic Acid can be avoided.


Professor Nadia Ali Azfar is Heading the Department of Dermatology, Gujranwala Medical College and Teaching Hospital. In addition to  fellowship in Dermatology she has done certification in Medical Education. She has been actively involved in research and has given talks at various national and international forums. She has been a guest speaker at SARCD conferences at Sri Lanka, India, Nepal and European Academy of Dermatology. She is Joint Secretary of Pakistan Association of Dermatologists and has also served as International Secretary for the same Association. Prof. Nadia is currently Chairperson of Institutional Review Board and Member Medical Education Department – Gujranwala Medical College. She is examiner for exit exams of