Background: Melasma is an acquired hyperpigmentary disorder characterised by light to dark-brown macules and patches, particularly affecting the sun-exposed areas. The management of melasma is challenging and requires long term treatment plan. Although various treatment options are available, no mode of treatment guarantees satisfactory results. Recent studies have shown that TXA can prevent UV pigmentation in melasma.

Aim: To compare the efficacy of oral tranexamic acid and topical tranexamic acid with microneedling in patients with melasma in a tertiary care hospital in south India.

Methods: It is a prospective, randomized, open-label study conducted among 60 melasma patients. Patients were divided into two groups, 30 patients were given oral tranexamic acid 250 mg  tablet twice daily for three months (Group A) and remaining 30 were treated with topical tranexamic acid with microneedling procedure done at  monthly interval  for 3 times (Group B), and followed up for three consecutive months. Percentage reduction in baseline Melasma Area and Severity Index (MASI) was assessed at 4-week intervals, and response was recorded.

Results: The mean pre MASI score in group ‘A’ was 13.4 ± 6.92 which is reduced to 3.99 ± 2.05 compared to group ‘B’ where it was 9.96 ± 2.79 and got reduced to 5.21 ± 1.63 after 3 months of treatment The average improvement in MASI score after 12 weeks of treatment for group ‘A’ was 70.29% which was comparatively higher than group ‘B’ in which improvement was only 48.02%.

Conclusions: On the basis of these results, therapeutic response was higher in the oral tranexamic acid group than topical tranexamic acid with microneedling group.

Keywords: Melasma, microneedling, tranexamic acid.

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Thillaikkarasi. A

Post Graduate, Department of Dermatology Venereology and Leprosy,

Rajah Muthiah Medical College & Hospital,

Annamalai University, Chidambaram, India – 608002.