Study evaluating the efficacy of topical and injected tranexamic acid in treatment of melasma

Introduction: Melasma is an acquired hypermelanosis of multifactorial etiology and diffi cult to treat. Tranexamic acid (TA) has been studied as an alternative therapy. Objective: To evaluate the effi cacy and safety of TA in treatment of melasma, comparing the use of localized microinjection versus topical therapy. Material and Method: Eighteen women with melasma were selected and treated for 12 weeks. Group A: at-home topical application of TA 3% twice a day. Group B: intradermal injections of TA (4 mg/ml) weekly. Before and after treatment, the groups were compared according to the following parameters: photographic evolution, MASI evolution, self-assessment and colorimetry. Results: Seventeen patients completed the study. In group A, photographic evaluation showed improvement in 12,5%, worsening in 50%, and 37.5% had no change. In group B, there was improvement in 66.7% and 22.2% had no change. For the MASI, there was signifi cant improvement (p = 0.0026), with no difference between treatments (p = 0.6512). In group A selfassessment, 37.5% of the patients rated as good and 50% as imperceptible. In group B, 66.7% rated as good and 33.3% as imperceptible. Colorimetric evaluation showed significant improvement on both treatments (p = 0.0008). Conclusion: Although the subjective clinical evaluation has demonstrated the superiority of injected treatment, in objective evaluation, both treatments were significantly effective, presenting TA as a promising new therapeutic option for melasma.

Keywords: TRANEXÂMIC ACID, MELASMA, THERAPEUTICS, THERAPY