Efficacy of intradermal tranexamic acid in melasma
Keywords:
Melasma; Tranexamic acid (TA); Intradermal microinjectionsAbstract
Objective To determine the efficacy of intradermal tranexamic acid (TA) in the patients of melasma. Methods This study was conducted in Dermatology OPD, Punjab Rangers Teaching Hospital over a period of 4 months from 14-08-2022 to 14-12-2022. A total number of 32 patients of melasma were enrolled after informed written consent. 2mL of concentrated tranexamic acid (50mg/ml) was injected intradermally, 1 ml on either side of face 1cm apart over the affected area. A total of 4 sessions were carried out, followed after every 2 weeks. Results were interpreted on the basis of MASI scoring before, during and after completion of the sessions. A mild topical steroid application was advised for 2 days. Sunscreen application was essentially prescribed. Results Out of 32 enrolled patients of melasma, 56% showed 61-100% reduction in MASI scoring, which constituted a majority. Conclusion We concluded that un-diluted intra dermal tranexamic acid is an excellent treatment modality for treatment of melasma without any side effects.References
Sheth VM, Pandya AG. Melasma: a comprehensive update: part II. J Am Acad Dermatol. 2011;65(4):699-714.
Handel AC, Lima PB, Tonolli VM, Miot LD, Miot HA. Risk factors for facial melasma in women: A case-control study. Br J Dermatol. 2014;171:588-94.
Pérez-Bernal A, Muñoz-Pérez MA, Camacho F. Management of facial hyperpigmentation. Am J Clin Dermatol. 2000;1:261-8.
Li D, Shi Y, Li M et al. Tranexamic acid can treat ultraviolet radiation-induced pigmentation in guinea pigs. Eur J Dermatol. 2010;20(3):289-92.
Perper M, Eber AE, Fayne R. Tranexamic acid in the treatment of Melasma. Am J Clin Dermatol. 2017;18(3):373-81.
Kalluri H, Banga AK. Microneedles and transdermal drug delivery. J Drug Delivery Sci Technol. 2009;19:303-10.
M. Rodrigues and A. G. Pandya. Melasma: Clinical diagnosis and management options. Australasian J Dermatol. 2015;56(3):151-63
Guinot C, Chefaii S, Latreille J, Dhaoui MA, Youssef S, Jaber K et al. Aggravating factors for melasma: aprospective study in 197 Tunisian patients. J Eur Acad Dermatol Venereol. 2010;24:1060-9.
D. Li, Y. Shi, M. Li et al. Tranexamic acid can treat ultraviolet radiation-induced pigmentation in guinea pigs. J Eur Acad Dermatol Venereol. 2010;20:289-92.
L. Budamakuntla, E. Loganathan, D. Suresh et al. A randomised, open-label, comparative study of tranexamic acid microinjections and tranexamic acid with microneedling in patients with melisma. J Cut Aesth Surg. 2013;6(3):139.
Kourtney Pony, Kiyanna Williams, A Multimodal Approach to Melasma. Advances in Cosmetic Surgery. 2022;5:1-8.
V. Lajevardi, A. Ghayoumi, R. Abedini et al. Comparison of the therapeutic efficacy and safety of combined oral tranexamic acid and topical hydroquinone 4% treatment vs. topical hydroquinone 4% alone in melasma: a parallel-group, assessor- and analyst-blinded, randomized controlled trial with a short-term follow-up. J Cosmet Dermatol. 2017;16(2):235-42.
S. J. Kim, J.-Y. Park, T. Shibata, R. Fujiwara, and H. Y. Kang. Efficacy and possible mechanisms of topical tranexamic acid in melisma. Clin Exp Dermatol. 2016;41(5):480-5.
