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.
Keywords: Melasma, tranexemic acid, oral, microneedling
References
- Katsambas AD, Stratigos AJ, Lotti TM. Melasma. In: Andreas DK, Lotti TM, eds. European Handbook of Dermatological Treatments. 2nd ed. Springer; 2003. p. 336.
- Grimes PE. Melasma: etiologic and therapeutic considerations. Arch Dermatol1995;131:1453-7.
- Gilchrest BA, Fitzpatrick TB, Anderson RR, Parrish JA. Localization of melanin pigmentation in skin with Wood’s lamp. Br J Dermatol 1977;96:245-8.
- Menter A. Rationale for the use of topical corticosteroids in melasma. J Drugs Dermatol 2004;3:169-74.
- Maeda K, Naganuma M. Topical trans-4-aminomethylcyclohexanecarboxylic acid prevents ultraviolet radiation-induced pigmentation. J PhotochemPhotobiol 1998;47:136-41.
- Sivayathorn A. Melasma in Orientals. Clin Drug Investig1995;10:24-40.
- Romero C, Aberdam E, Larnier C, Ortonne JP. Retinoic acid as modulator of UVB-induced melanocyte differentiation. J Cell Sci 1994;107:1095-103.
- Perez-Bernal A, Munoz-Perez MA, Camacho F. Management of facial hyperpigmentation. Am J ClinDermatol 2000;1:261-8.
- Cho HH, Choi M, Cho S, Lee JH. Role of oral tranexamic acid in melasma patients treated with IPL and low fluence QS Nd:YAG laser. J Dermatol Treat 2013;24:292-6.
- Sadako N. Treatment of melasma with tranexamic acid. The Clin Rep 1979;13:3129-31.
- Nijor T. Treatment of melasma with tranexamic acid. Clin Res1979;13:3129-31.
- Budamakuntla L, Loganathan E, Suresh DH, Shanmugam S, Suryanarayan S, Dongare A, et al. Microinjections and microneedling in patients with melasma. J CutanAesthetSurg 2013;6:139-43.
- Liu H, Kou CC, Yeung CW. Effectiveness of tranexamic acid in treating melasma and observation of its safety (Chinese). Chin J Med AesthCosmet 2005;11:361-3.
- Sharma R, MahajanVK, MehtaKS, Chauhan PS, Rawat R, Shiny TN. Therapeutic efficacy and safety of oral tranexamic acid and that of tranexamic acid local infiltration with microinjections in patients with melasma: a comparative study. Clin and ExpDermatol 2017;1:1-17.
Corresponding Author
Saru Thakur
Deptt. of Dermatology, Leprosy and Venereology, Indira Gandhi Medical College, Shimla,
Himachal Pradesh, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i8.73
