Comparative study of oral tranexamic acid and triple combination versus tranexamic acid through microneedling in patients of melisma
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20193226Keywords:
Camparative study, Melasma, Microneedling, Tranexamic acidAbstract
Background: Melasma can be difficult to treat due to the refractory and recurrent nature of condition. The aim of this study is to compare and evaluate the efficacy of oral tranexamic acid and triple combination versus tranexamic acid through microneedling in patients of melisma.
Methods: This is a prospective study with a sample size of 20, 10 in each treatment arm.10 patients (group-A) were given topical triple combination to apply daily at night and along with oral tranexamic acid 250 mg twice a day, while in the other arm (group-B), 10 patients were given procedural treatment of microneedling with tranexamic acid (4 mg/ml). Patients were followed up for 3 consecutive months. Clinical photograph was taken after each visit, and a modified melasma area and severity index was performed at the beginning and end of the treatment.
Results: According to melasma area and severity index, improvement in group-A was 65% as compared to 33% in group-B.
Conclusions: Triple combination is known as gold standard treatment in melasma, but because of its long term steroidal and tretinoin side effects we can consider microneedling with TXA as an adjuvant treatment.
References
Sheth VM, Pandya AG. Melasma: a comprehensive update: part-1. J Am Acad Dermatol. 2011;65(4):689-97.
Tamega AA, Miot LD, Bonfietti C, Gige TC, Marques ME, Miot HA. Clinical patterns and epidemiological characteristics of facial melasma in Brazilian women. J Eur Acad Dermatol Venereol. 2013;27(2):151-6.
Sivayathorn A. Melasma In Orientals. Clin Drug Invest. 1995;10(2):34-4.
Lee JH, Park JG, Lim SH, Kim JY, Ahn KY, Kim MY et al. Localised intradermal microinjection of tranexamic acid for treatment of melasma in Asian patients: a preliminary clinical trial. Dermatol Surg. 2006;32:626-31.
Maeda K, Naganumma M. Topical trans-4-aminomethylcyclohexanec arboxylic acid prevents ultraviolet radiation induced pigmentation. J Photochem Photobiol B. 1998;47:136-41.
Kondou S, Okada Y, Tomita Y. Clinical study of effect of tranexamic acid emulsion on melasma and freckles. Skin Res. 2007;6:309-15.
Maeda K, Naganumma M. Topical trans-4-aminomethylcyclohexanec arboxylic acid prevents ultraviolet radiation induced pigmentation. J Photochem Photobiol B. 1998;47:136-41.
Tse TW, Hui E. Tranexamic acid: an important adjuvantin the treatment of melasma. J Cosmet Dermatol. 2013;12:57-66.
Kaushik S, Hord AH, Denson DD, McAllister DV, Smitra S, Allen MG, et al. Lack of pain associated with microfabricated microneedles. Anesth Analg. 2001;92:502-4.
Gupta AK, Gover MD, Nouri K, Taylor S. The treatment of melasma: a review of clinical trials. J Am Acad Dermatol. 2006;55:1048-65.
Hsiao CY, Sung HC, Hu S, Fractional CO2 laser treatment to enhance skin permeation of tranexamic acid with minimal skin disruption. Dermatology. 2015;230(3):269-75.
Kim EH, Kim YC, Lee ES, Kang HY. The vascular characteristics of melasma. J Dermatol Sci. 2007;46:111-6.
Zhu HJ, Yang XH. The clinical study of acidum tranex-amicum on melasma. Pharm Program. 2001;3:178-81.
Mafune E, Morimoto Y, Lizuka Y. Tranexamic acid and melasma. Farmacia 2008;44:437-42.
