Comparison between the efficacies of topical tranexamic acid versus intralesional tranexamic acid in treatment of melasma
trenexemic acid in melasma
DOI:
https://doi.org/10.66344/jpad.v33i3.2254Keywords:
pakistani women, melasma, tanexemic acid, intralesional, topicalAbstract
Objective Melasma is characterized as grey brown patches of pigmentation on photo exposed areas of body, often requiring a multifaceted approach for its management in refractory. Topical tranexamic acid is commonly used but studies claimed that intralesional injection of tranexamic acid was more efficacious. The objective of the study is to compare the efficacy of tranexamic acid intralesional (localized microinjections) versus topical therapy in the treatment of melasma.
Methods 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 Fitz-Patrick 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.
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