Comparative Efficacy of Oral Tranexamic Acid versus Oral Glutathione when Given in Combination with Modified Kligman Regimen in the Management of Melasma

Abstract

ABSTRACT Introduction: Melasma is a common acquired pigmentation disorder over the sun exposed areas found commonly in our country. Oral tranexamic acid and glutathione have been shown to have significant efficacy when given along with topical modified Kligman regimen. Aims: To compare the efficacy of oral tranexamic acid versus oral glutathione given in combination with modified Kligman regimen in the management of melasma. Settings and Design: An open label randomized controlled trial was conducted in the skin OPD of a tertiary level hospital in Northern India. Materials and Methods: The study group consisting of 96 patients was categorized into two groups; group A received oral tranexamic acid 250 mg twice daily in combination with a modified Kligman regimen and group B received oral Glutathione 500 mg once daily with a modified Kligman regimen. mMASI score was used to make the assessment. mMASI scores were measured at baseline, 4th, 8th, and 12th week. Intragroup and intergroup comparison was done using analysis of variance (ANOVA) and Chi-square test statistical methods. Results: Ninety patients completed the study. Both the groups showed a significant fall in the mMASI score; group A showed a statistically significant fall in the score vis a vis the group B. Conclusion: Oral tranexamic acid with a modified topical Kligman regimen has a slight edge over oral glutathione given with topical modified Kligman’s regimen in the treatment of melasma.