The effectiveness of intradermal injection and topical tranexamic acid in melasma

Melasma is a hyperpigmentation disorder caused by the hyperactivity of epidermal melanocytes in the facial area that is very common in Asian races. Tranexamic acid is a fibrinolytic agent that has antiplasmin properties and is shown to be safe in preventing pigmentation. This study elucidates the effectiveness of intradermal injection compared with topical tranexamic acid (TA) in melasma. Methods The research subjects were separated into two groups: intradermal tranexamic acid injections every four weeks for eight weeks and topical tranexamic acid given by compressed dressing every two weeks for eight weeks. MASI score and melanin index were measured at the beginning and end of the study. Results Eighteen patients (56) received an intradermal tranexamic acid injection, and 14 patients (44) received topical tranexamic acid. There were significant mean differences in melanin index and MASI score before and after treatment between the topical and injection TA groups (p <0.05). Conclusion TA injection is more effective in reducing MASI scores and melanin index compared to topical TA in the treatment of melasma, with longer treatment intervals and lower cost. © 2023 Pakistan Association of Dermatologists. All rights reserved.