Comparing the Efficacy of Patelet-rich Plasma (PRP) versus Tranexamic Acid (4mg/mL) as Intradermal Treatments of Melasma

Objective To compare the efficacy of intradermal platelet-rich-plasma vs. intradermal tranexamic acid in treatment of melasma. Study design Non-randomised controlled trial. Place and duration of study Sheikh Zayed Hospital, Rahim Yar Khan from 1st October 2019 to 30th April 2020. Methodology Cases of melasma from either gender with age 20-40 years, were included. Diagnosis of melasma was made clinically on the basis of hyperpigmentation at sun-exposed areas and by Wood's lamp. Severity was labelled on the basis of melasma area and severity index (MASI) score. Cases in group A were managed with 1 ml of intradermal platelet-rich plasma (PRP) and those in group B were offered intradermal tranexamic acid in a dose of 4 mg. The treatment was offered every 4th week and for a total period of 12 weeks; and final outcome was seen at 24th week. At every visit, the cases were noted for their mean MASI score. Results In this study, there were a total of 64 cases, 32 in each group. There were 19 (59.38%) males in group A and 16 (50%) in group B (p=0.61). Mean age in group A and B was 24.63 ± 9.87 vs. 23.94 ± 8.93 years (p= 0.76). Mean MASI score at baseline was 29.84 ± 5.14 vs. 29.56 ± 4.39, p=0.21. MASI was significantly better in group A at 4 weeks where score was 29.44 ± 5.35 vs. 28.69 ± 4.10, p=0.01. Mean MASI was 12.81 ± 1.78 vs. 18.38 ± 3.50, p=00001 at 12 weeks and 8.72 ± 3.40 vs. 14.97±4.33, p=0.02 at 24 weeks in group A and B, respectively. Conclusion Intradermal PRP is significantly better than intradermal tranexamic acid in management of melasma. Key Words: Melasma, Tranexamic acid, PRP, MASI.