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.