Publication:

A study of intradermal tranexamic acid for treatment in melasma patients

Background Melasma is a common acquired pigmentary dermatosis due to a disorder in the melanogenesis process. Although several treatments are currently used, it remains a great challenge. It was recently reported that intradermal tranexamic acid (TA- plasmin inhibitor) is an effective treatment for melasma. Aims of the study were to assess the efficacy and side-effects of localized microinjection of TA for the treatment of melasma.

Methods A total of 30 patients with melasma, who did not respond to topical therapy were included in the study, after taking informed consent. The severity and extent of pigmentation was assessed by modified melasma area severity index (MASI). Patients were then administered localized microinjections (10 mg/ml) of TA weekly for 6 weeks. The response to treatment was assessed by MASI and clinical photographs at each session and after 3 months of stopping treatment.

Results Among 30 patients significant decrease in the MASI from baseline was observed. 36.6% patients showed >75% improvement, 43.3% showed 50-75% improvement, 6.8% showed 30-49% improvement, and 13.3% showed <30% improvement at the end of 6 weeks. Side effects were minimal, and all the patients tolerated the treatment well. At 12 weeks 32% of patients developed mild recurrences and the rest of the patients maintained the same MASI.

Conclusion Based on our results, intradermal TA (10 mg/ml) can be used as potentially new, effective and safe treatment for melasma.