Comparative Efficacy of Oral Tranexamic Acid and Trans-epidermal Delivery of Tranexamic Acid by MicroNeedling in Melasma

Abstract

Background: Melasma is an acquired hyperpigmentary disorder of photo-exposed
skin. It leads to lowered self-esteem. Treatment of melasma is not very rewarding
and demands a multimodal approach. Tranexamic acid (TxA) acts as an inhibitor of
melanin synthesis. There are multiple methods of delivering this drug to the site of
melanization.
Aims: To compare the therapeutic efficacy and safety of tranexamic acid
administered by microneedling and oral route in patients of melasma.
Methods: A prospective randomized study was conducted in 30 consecutive
patients of melasma, who were enrolled into two groups; group A (received TxA by
microneedling) and group B (oral TxA). The baseline details of melasma were
recorded and MASI was recorded at 4,8 and 12 weeks.
Results: Females outnumbered males in a ratio of 4:1.There was no significant
difference in the two groups on the basis of sex, age, duration of melasma, mean
MASI score at baseline and pattern of melasma. Reduction in MASI score was
more in oral TxA group but the difference was not statistically significant(5.89 vs
4.25). More than 50 % improvement was seen in 40 % patients in group B and 20%
in group A.
Conclusion: Tranexamic acid is an effective treatment of melasma, the route of
administration does not significantly alter the outcome
.