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Author Spotlight: Non-Surgical Treatment of Melasma– Microneedling with Tranexamic Acid
Published on: January 19, 2024
Treatment of Melasma with Intralesional Tranexamic Acid Versus Cryotherapy
1All authors are with the Dermatology Department, Faculty of Medicine at Zagazig University in Zagzig, Egypt.
Background:
Melasma is a relatively common, acquired facial skin disorder of hyperpigmentation. Though it occurs in both sexes, nearly 90% of patients are female. It manifests as hyperpigmented macules and patches distributed symmetrically on the face, neck, and, rarely, the upper limbs. OBJECTIVE: The aim of this study was to evaluate and compare the clinical efficacy and adverse effects of intralesional injection of tranexamic acid (TA) versus cryotherapy in the treatment of melasma.
Methods:
Patients were divided into two groups: Group A and Group B. Group A comprised 28 patients aged 27 to 50 years. They received localized intralesional injections of TA. According to Wood's light examination, patients were divided into two subtypes; 13 patients with mainly dermal-type melasma and 15 patients with mainly mixed-type melasma. Family history was obtained in 12 patients. Group B comprised 28 patients aged 29 to 46 years were included. They were treated with cryotherapy. According to Wood's light examination, the patients were divided into two subtypes of melasma; 8 patients with mainly dermal-type melasma and 10 patients with mainly mixed-type melasma.
Results:
There were no statistically significant differences between Group A and Group B according to contraception, sun exposure, and family history. There was a statistically significant difference between Group A and Group B according to previous treatment. There was no statistically significant difference between the two groups according to drug allergy. There were no statistically significant differences according to systemic disease or general examination.
Conclusion:
Intralesional tranexamic acid is a safe and effective method for the treatment of melasma with no risk of PIH, thrombosis, or bleeding; however, more sessions with longer follow-up periods are recommended, as the final response may take several months to occur. Cryotherapy was neither safe nor effective due to the risk of PIH.
Insights
Intralesional tranexamic acid (TA) is a safe and effective melasma treatment, unlike cryotherapy which carries risks. Further sessions and follow-up are recommended for optimal TA results in hyperpigmentation management.
Area of Science:
- Dermatology
- Aesthetic Medicine
Background:
- Melasma is a common facial hyperpigmentation disorder, predominantly affecting females.
- It presents as symmetrical macules and patches on the face and neck.
- The study focuses on treating this acquired skin condition.
Purpose of the Study:
- To compare the clinical efficacy of intralesional tranexamic acid (TA) versus cryotherapy for melasma.
- To evaluate and compare the adverse effects of both treatment modalities.
Main Methods:
- 28 patients received intralesional TA injections (Group A).
- 28 patients underwent cryotherapy (Group B).
- Patients were subtyped based on melasma depth (dermal/mixed) using Wood's light.
Main Results:
- No significant differences between groups regarding contraception, sun exposure, or family history.
- A significant difference was noted in previous treatment history between groups.
- No significant differences were found for drug allergy, systemic disease, or general examination findings.
Conclusions:
- Intralesional TA is a safe and effective melasma treatment with no risk of post-inflammatory hyperpigmentation (PIH), thrombosis, or bleeding.
- Cryotherapy poses a risk of PIH and is considered neither safe nor effective.
- Longer follow-up and additional sessions may be needed for optimal TA outcomes.
