Tranexamic Acid Mesotherapy for Melasma: An Interventional Study

Tranexamic acid (TXA), an anti-fibrinolytic agent traditionally used to manage blood loss, has shown promising results in the treatment of melasma. Studies on the efficacy of intradermal TXA, with or without adjuvants, in treating melasma remain limited. There is also a lack of consensus on optimal dosing. This study aims to assess the efficacy of intradermal TXA for the treatment of melasma.

A total of 30 patients aged 20 to 60 years, diagnosed with melasma, were identified at the Department of Dermatology, Benazir Bhutto Hospital, Rawalpindi, Pakistan, from October 2021 to April 2022. 0.05ml tranexamic acid (4mg/ml) was injected intradermally into the melasma lesions at 1cm intervals with a 0.5 mL insulin syringe and a 30-gauge needle. Intradermal TXA injections were repeated weekly for 12 weeks. Baseline and 4-, 8-, and 12-week modified Melasma Areas Severity Index (mMASI) were recorded. Clinical photographs were taken at 4, 8, and 12 weeks.

Ages ranged from 20 to 60 years, with a mean age of 32.17 ± 6.70 years. 90.0% of patients were between 20 and 40 years of age (n=27). The mean baseline mMASI score was 8.58 ± 3.66. Mean mMASI scores at 4, 8, and 12 weeks were noted as 4.88 ± 2.22, 2.83 ± 1.37, and 1.38 ± 0.63, respectively. Over a 12-week treatment course of intradermal TXA, a significant reduction in mMASI score by 7.20± 3.71 was noted (P<0.0001).

Weekly TXA injections (0.05 mL, 4 mg/ml) for 12 weeks resulted in a significant reduction in mMASI score (P<0.0001).  .