Efficacy of topical versus intradermal injection of Tranexamic Acid In Egyptian melasma Patients: A randomised clinical trial

• Published in: Australasian journal of dermatology 2021-08, Vol.62 (3), p.e373-e379
• Main Authors: Badran, Aya Y., Ali, Ahmed U., Gomaa, Ahmed S.
• Format: Article
• Language: English
• Subjects: Administration, Cutaneous; Adult; Antifibrinolytic agents; Antifibrinolytic Agents - administration & dosage; chloasma; Clinical trials; Contraceptives; Egypt; Female; Humans; Hyperpigmentation; Injection; Injections, Intradermal; Melanosis - drug therapy; melasma; Melasma Area and Severity Index; Middle Aged; Patients; pigmentation; Severity of Illness Index; Topical application; tranexamic acid; Tranexamic Acid - administration & dosage; Treatment Outcome
• ISSN: 0004-8380; 1440-0960
• DOI: 10.1111/ajd.13575

Background Melasma is one of the common pigmentary problems affecting females in our community, owing to the frequent use of hormonal contraceptives as well as our sunny climate. A lot of treatment options are available but none of them is completely satisfactory. Many patients prefer the use of topical preparations and minimally invasive methods. Tranexamic acid (TA) is a potential treatment option for hyperpigmentation with different delivery routes. Aim We designed the study in order to evaluate the efficacy of TA in melasma using 2 different routes of delivery. Patients and methods A randomised clinical trial was performed on 60 female patients with melasma, they randomly divided into three groups; A, B and C. Group (A) patients received TA (4 mg/mL) intradermal injections every 2 weeks with, group B received TA (10 mg/mL) intradermal injections every 2 weeks, group C received TA cream (10% concentration) twice daily, treatment continued for 12 weeks in all groups. Melasma Area and Severity Index (MASI) scores were measured for each patient before and after completion of treatment. Results The percentage of MASI score reduction was highest in group B (62.7%) versus (39.1%) in group A, while the percentage of MASI reduction was the lowest in group C (4.2%). Conclusion Tranexamic acid is a safe effective and well‐tolerated treatment option for melasma patients. Intradermal injection of TA leads to better results than the topical application. Topical TA cream (even in a high concentration) produce fair improvement of melasma.