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Tranexamic acid (TXA) effectively treats melasma via intradermal injection or microneedling. While both methods show efficacy, microneedling offers superior patient satisfaction with no significant adverse effects.

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Area of Science:

  • Dermatology
  • Cosmetic Science
  • Pharmacology

Background:

  • Melasma is a common hyperpigmented skin condition.
  • Tranexamic acid (TXA) is known to inhibit UV-induced pigmentation by affecting the plasminogen-plasmin pathway.

Purpose of the Study:

  • To compare the therapeutic efficacy and safety of intradermal TXA injection versus TXA combined with microneedling for melasma treatment.
  • To assess patient satisfaction with each treatment modality.

Main Methods:

  • A split-face study involving 56 female patients with bilateral melasma.
  • Treatments administered over 6 sessions every 2 weeks: intradermal TXA on one side, TXA with microneedling on the other.
  • Efficacy assessed via modified Melasma Area Severity Index (mMASI) scores, blinded photographic review, and patient self-assessment.

Main Results:

  • Both treatment methods significantly reduced mMASI scores compared to baseline.
  • No significant difference in clinical efficacy was observed between intradermal TXA and TXA with microneedling.
  • Patient satisfaction was significantly higher with the TXA microneedling side.
  • No significant adverse effects were reported for either treatment.

Conclusions:

  • Intradermal TXA injection and TXA with microneedling are safe and effective for melasma.
  • Microneedling TXA offers a more satisfying treatment experience for patients.
  • Further research may explore optimal protocols for TXA microneedling in melasma management.