Comparative Study between the Efficacy of Intradermal Injection and Oral Administration of Tranexamic Acid in Treatment of Melasma

Abstract

Melasma is an acquired hypermelanosis characterized by light to dark-brown macules and patches on sun-exposed areas. Most cases of melasma occur in women in the reproductive age with darker skin types, but all ages, races, and skin colours may be affected, Tranexamic acid is an antiplasminogen agent with well-documented efficacy against melasma. comparison of the efficacy and safety of intradermal injection and systemic administration of tranexamic acid in treatment of melasma. 40 female patients complaining of melasma were divided randomly into two groups, group A and B. mMASI score before and after treatment did not differ significantly between both groups . The response to the treatment was best in group A who was received intradermal injection(4mg/ml)TXA, followed by group B who was received oral TXA in a dose of 250 mg twice daily for 3 months. In group A, there was excellent response was detected in 6 patients (30%), good response was detected in 6 patients (30%), moderat response was detected in 5 patients (20%), mild response was detected in 1 patient (5%) and no response was detected in 2 patient (10%). In group B, excellent response was detected in 0 patients (0%) good response was detected in 1 patients (5%), moderat response was detected in 12 patients (60%), mild response was detected in 3 patient (15%) and no response was detected in 4patient (20%). Tranexamic acid may be a new treatment option for melasma. It is a safe, well-tolerated and effective treatment method.