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Related Experiment Video

Updated: Jun 11, 2026

Roller Microneedle Combined with Tranexamic Acid Solution in Treating Melasma

Roller Microneedle Combined with Tranexamic Acid Solution in Treating Melasma

Published on: January 19, 2024

Interventions for melasma.

Ratna Rajaratnam¹, James Halpern, Asad Salim

¹Department of Dermatology, Selly Oak Hospital, Old Matrons House, Raddlebarn road, Selly Oak, Birmingham, UK, B29 6JD.

The Cochrane Database of Systematic Reviews

|July 9, 2010

Summary

Triple-combination cream is more effective for melasma than hydroquinone alone. Further high-quality trials are needed to assess melasma treatments due to poor study quality.

Area of Science:

Dermatology
Cosmetic Science

Background:

Melasma is a common facial pigmentary disorder characterized by grey-brown patches.
Current melasma treatments are often unsatisfactory for patients.

Purpose of the Study:

To evaluate the effectiveness of various topical and systemic interventions for epidermal, dermal, and mixed melasma.

Main Methods:

A systematic review of randomized controlled trials (RCTs) was conducted.
Searches included major databases like Cochrane, MEDLINE, and EMBASE up to May 2010.
Two authors independently assessed study quality, selected trials, and extracted data.

Main Results:

Twenty studies with 2125 participants evaluated 23 treatments; data pooling was not feasible due to heterogeneity.

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Triple-combination cream (hydroquinone, tretinoin, fluocinolone acetonide) showed superior efficacy over hydroquinone alone and dual combinations.

Azelaic acid (20%) was more effective than 2% hydroquinone, and Thiospot demonstrated superiority over placebo. Tretinoin showed mixed results against placebo but improved melasma objectively.

Common adverse events were mild and transient, including skin irritation.

Conclusions:

The overall quality of existing melasma treatment studies is poor.
Current therapeutic options for melasma are inadequate.
High-quality RCTs with long-term outcome assessments are necessary to guide clinical practice.