| ORIGINAL ARTICLE |
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| Year : 2019 | Volume
: 6
| Issue : 2 | Page : 84-95 |
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Comparative study of efficacy of intradermal tranexamic acid versus topical tranexamic acid versus triple combination in melasma
Shruti S Patil, Ashish R Deshmukh
Department of Dermatology, MGM Medical College and Hospital, Aurangabad, Maharashtra, India
Correspondence Address:
Shruti S Patil
Department of Dermatology, MGM Medical College and Hospital, Aurangabad, Maharashtra
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/Pigmentinternational.Pigmentinternational_
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Background: Melasma, a hypermelanotic disorder, is challenging to treat as it needs long-term management. Intradermal tranexamic acid (TA), a plasmin inhibitor, has been tried for melasma in Korean and Iranian patients but not studied in skin type of Indian patients. TA cream topically as well as fluocinolone-based triple combination along with intradermal TA have not been studied in the literature so far in melasma. Objective: This study is designed to study the efficacy of intradermal TA vs topical TA vs triple combination (hydroquinone 2%, tretinoin 0.025%, fluocinolone acetonide 0.01%) for the treatment of melasma. Materials and Methods: A total of205 patients of melasma attending Dermatology OPD were enrolled in the study and randomly assigned into three groups. Groups A, B, and C were given intradermal TA, topical 3% TA, and triple combination, respectively, from November 2016 to May 2018 and asked to follow-up every month for 6 months. Total 180 patients completed the study and clinical evaluation was done using melasma area severity index (MASI) score. The results were analyzed using SPSS-22 and comparison of three groups were assessed by applying analysis of variance. Results: The MASI score at baseline and at 6 months for Groups A, B, and C was 15.4 and 2.2, 15.4 and 6.4, and 15.3 and 5.4, respectively. MASI score decreased in all three groups but it was statistically significant in Group A (TA group) that had the least MASI score followed by triple combination therapy. Conclusion: On the basis of these results, TA can be used as potentially a new, effective, safe, and promising therapeutic agent in melasma.
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