Efficacy and Safety of tranexamic acid versus vitamin c after microneedling in treatment of melasma: Clinical and Dermoscopic study

BACKGROUND: Melasma is a common acquired symmetrically distributed hyperpigmented macules of sun-exposed skin. Skin microneedling acts as a transdermal delivery system that facilitates the penetration of lightening agents to deeper layers of skin. OBJECTIVE: Clinical and dermoscopic evaluation of the efficacy and safety of topical tranexamic acid versus topical vitamin C after microneedling for melasma treatment. PATIENTS AND METHODS: Twenty patients with facial melasma were enrolled in a split-face prospective, randomized uncontrolled study. The right side of the face was treated with topical tranexamic acid after dermapen microneedling, while the left side of the face was treated with topical vitamin C after dermapen microneedling. Sessions were done every 2 weeks for 6 sessions. The Hemi-MASI score and dermoscopic examination before and after treatment were done. RESULTS: Hemi-MASI score was reduced after treatment on both sides of the face, besides improvement of the pigmented lesions showed by dermoscopy on both sides and improvement of the vascular component on the tranexamic acid treated side. CONCLUSION: Topical tranexamic acid or vitamin C application after dermapen microneedling was an effective and safe technique in melasma treatment with minimal side effects, and vascular component improvement by tranexamic acid.