Efficacy of intralesional tranexamic acid in melasma: Assessment with Melasma Area Severity Index and Dermatology Quality of Life Index

Background and Design: Melasma is a common hypermelanotic condition, mostly observed in women, which affects their psychological, emotional, and social well-being as well as their quality of life.Although melasma is relatively resistant to treatment, various therapeutic options have been attempted until date.Recently, microneedling and microinjection tranexamic acid were performed.To compare the therapeutic effectiveness of triple combination therapy with tranexamic acid injection and assess the impact of response on melasma by comparing the pre-and post-treatment Melasma Area Severity Index (MASI) and Dermatology Quality of Life Index (DLQI) scores.Materials and Methods: A total of 70 melasma patients were selected and assigned to two groups of 35 patients each based on the interventional randomized control study.One group was treated with a topical triple combination therapy-hydroquinone (2%), mometasone (0.1%), and tretinoin (0.025%), and the other group with injectable tranexamic acid.The MASI scores and DLQI were assessed for both the groups of patients at the baseline and then 6 weeks later along with serial photographs.Results: Significant reduction in MASI and DLQI scores were noted in the intralesional tranexamic acid group of patients (p=0.032).The mean change in MASI with tranexamic acid was 1.22 and with DLQI was 2.03.Conclusion: Injectable tranexamic acid is a promising treatment option for melasma.Further studies are however warranted with a larger sample size and for a longer duration to determine its long-term benefits.Treatment of melasma is beneficial for the patient both physically and emotionally.