Background Melasma is a common acquired symmetrically distributed hyperpigmented macules of sun‐exposed skin. Skin microneedling acts as a transdermal delivery system that facilitates the penetration of lightening agents to deeper layers of skin. Objective Clinical and dermoscopic evaluation of the efficacy and safety of topical tranexamic acid versus topical vitamin C after microneedling for melasma treatment. Patients and Methods Twenty patients with facial melasma were enrolled in a split‐face prospective, randomized uncontrolled study. The right side of the face was treated with topical tranexamic acid after dermapen microneedling, while the left side of the face was treated with topical vitamin C after dermapen microneedling. Sessions were done every 2 weeks for 6 sessions. The Hemi‐MASI score and dermoscopic examination before and after treatment were done. Results Hemi‐MASI score was reduced after treatment on both sides of the face, besides improvement of the pigmented lesions showed by dermoscopy on both sides and improvement of the vascular component on the tranexamic acid treated side. Conclusion Topical tranexamic acid or vitamin C application after dermapen microneedling was an effective and safe technique in melasma treatment with minimal side effects, and vascular component improvement by tranexamic acid.
White piedra (WP) of the scalp is a superficial mycotic infection of the hairs frequently reported in tropical humid regions as Southeast Asia, South America, and Middle East. 1 The majority of cases occur in children and young adult females. 2 It is characterized clinically by the presence of multiple whitish soft nodules along the hair shafts. The patients may also present with dry lusterless hair, hair breakage, and frayed ends. 3 Direct microscopic examination and culture of infected hair enable a definitive diagnosis to be made. 4 Treatment of scalp WP is challenging as eliminating the fungus through cutting the hair is not always acceptable by the patients. Moreover, lack of response and post-treatment relapse is frequently encountered after topical antifungal therapy. 3 Persistent infection is more common in patients with long hair and those who reutilize their infected hairbrushes. 5 It was also hypothesized that the organism may cause penetration of the hair cuticle by its keratolytic activity, which
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