Comparative study of localised intradermal microinjection of tranexamic acid and oral tranexamic acid for the treatment of melasma

Vinma H. Shetty, Monisha Shetty


Background: Melasma is an acquired hypermelanosis affecting the sun- exposed areas of the skin, most commonly the face and neck. Different treatment modalities have been utilized in different studies with varying, not so satisfactory outcomes. The aim of the study was to compare the efficacy of localized intradermal microinjection of tranexamic acid with oral tranexamic acid in melasma patients.

Methods: It is a prospective comparative study. All patients enrolled in the study were divided into 2 groups - twenty in each treatment group. In group A, patients were given intradermal injections of tranexamic acid (4 mg/ml) once at three week intervals (0, 3, 6, 9, 12 weeks) for 12 weeks. Group B patients were given oral tranexamic acid 250 mg twice a day for 12 weeks. Following parameters were evaluated before and after 12 weeks of treatment: a) digital photographs b) MASI score c) patient subjective assessment d) dermoscopic photographs. Software (SPSS, version 16.0 statistical packages) was used.

Results: Clinical efficacy of the treatment in 2 different groups showed higher efficacy with intradermal microinjection (35.6%) compare to oral tranexamic acid (21.7%). Patient's subjective assessment showed good improvement in 63.15% of cases in group A, whereas in group B 27.8% of cases showed good improvement.

Conclusions: Intralesional localized microinjection of tranexamic acid is a promising new therapeutic modality for the treatment of resistant melasma.


Melasma, Tranexamic acid, Microinjection

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