Abstract
Background: Melasma is an acquired hyperpigmentary disorder characterised by light to dark-brown macules and patches, particularly affecting the sun-exposed areas. The management of melasma is challenging and requires long term treatment plan. Although various treatment options are available, no mode of treatment guarantees satisfactory results. Recent studies have shown that TXA can prevent UV pigmentation in melasma.
Aim: To compare the efficacy of oral tranexamic acid and topical tranexamic acid with microneedling in patients with melasma in a tertiary care hospital in south India.
Methods: It is a prospective, randomized, open-label study conducted among 60 melasma patients. Patients were divided into two groups, 30 patients were given oral tranexamic acid 250 mg tablet twice daily for three months (Group A) and remaining 30 were treated with topical tranexamic acid with microneedling procedure done at monthly interval for 3 times (Group B), and followed up for three consecutive months. Percentage reduction in baseline Melasma Area and Severity Index (MASI) was assessed at 4-week intervals, and response was recorded.
Results: The mean pre MASI score in group ‘A’ was 13.4 ± 6.92 which is reduced to 3.99 ± 2.05 compared to group ‘B’ where it was 9.96 ± 2.79 and got reduced to 5.21 ± 1.63 after 3 months of treatment The average improvement in MASI score after 12 weeks of treatment for group ‘A’ was 70.29% which was comparatively higher than group ‘B’ in which improvement was only 48.02%.
Conclusions: On the basis of these results, therapeutic response was higher in the oral tranexamic acid group than topical tranexamic acid with microneedling group.
Keywords: Melasma, microneedling, tranexamic acid.
References
- Poojary S, Minni K (2015) Tranexamic Acid in Melasma: A Review. Pigmentary Disorders 2:228. doi: 10.4172/2376-0427. 1000228.
- Sarkar R, Arora P, Garg VK, Sonthalia S, Gokhale N. Melasma update. Indian Dermatology Online Journal. 2014; 5(4):426-435. Sarkar R, Chugh S, Garg VK. Newer and upcoming therapies for melasma. Indian J Dermatol Venereol Leprol 2012; 78:417-28.
- Nouveau S, Agrawal D, Kohli M, Bernerd F, Misra N, Nayak CS. Skin hyperpigmentation in Indian population: Insights and best practice. Indian J Dermatol 2016;61:487-95.
- Bandyopadhyay D. Topical Treatment of Melasma. Indian Journal of Dermatology. 2009; 54(4): 303-309.
- Katerina Damevska. New Aspects of Melasma Serbian Journal of Dermatology and Venereology 2014; 6 (1): 5-18.
- Maeda K, Tomita Y. Mechanism of the inhibitory effect of tranexamic acido n melanogenesis in cultured human melanocytes in the presence of keratinocyte-conditioned médium. J Health Sci 2007; 53(4):389-96.
- Kim EH, Kim YC, Lee ES, Kang HY (2007)The vascular characteristics of melasma. J DermatolSci 46: 111-116.
- Kim MS, Bang SH, Kim JH, Shin HJ, Choi JH, Chang SE. Tranexamic acid diminishes laser‑induced melanogenesis. Ann Dermatol 2015; 27:250‑6.
- Wu S, Shi H, Wu H, Yan S, Guo J, et al. (2012)Treatment of melasma with oral administration of tranexamic acid. Aesthetic PlastSurg 36: 964-970.
- Neerja Puri* Oral Tranexamic Acid Versus Triple Combination for The Treatment of Melasma, research article; Jacobs Journal of Experimental Dermatology and Research, 2015 Cristina C.Co, M.D., Ma. Flodeliz Abad.
- Casinathan, M.D., FPDS, transepidermal delivery of tranexamic acid vs.placebo using the dermaroller in the treatment of melasma, http://www.cassiacorrea.com.br
- Karn D, K C S, Amatya A et al. Oral tranexamic acid for the treatment of melasma. Kathmandu Univ Med J. 2012;10:40-3.
- Lee, Hwee Chyen, Thng, Tien Guan Steven, Goh, Chee Leok Oral tranexamic acid (TA) in the treatment of melasma: A retrospective analysis Journal of the American Academy of Dermatology, ISSN: 1097-6787, Vol: 75, Issue: 2, Page: 385-92 Publication Year:2016.
Corresponding Author
Thillaikkarasi. A
Post Graduate, Department of Dermatology Venereology and Leprosy,
Rajah Muthiah Medical College & Hospital,
Annamalai University, Chidambaram, India – 608002.
DOI: https://dx.doi.org/10.18535/jmscr/v5i11.151
