A randomised, open-label, comparative study of tranexamic acid microinjections and tranexamic acid with microneedling in patients with melasma

Abstract

Background:Melasma is a common cause of facial hyperpigmentation with significant cosmetic deformity. Although several treatment modalities are available, none is satisfactory.Aim:To compare the therapeutic efficacy and safety of tranexamic acid (TA) microinjections versus tranexamic acid with microneedling in melasma.Materials and Methods:This is a prospective, randomised, open-label study with a sample size of 60; 30 in each treatment arms. Thirty patients were administered with localised microinjections of TA in one arm, and other 30 with TA with microneedling. The procedure was done at monthly intervals (0, 4 and 8 weeks) and followed up for three consecutive months. Clinical images were taken at each visit including modified Melasma Area Severity Index MASI scoring, patient global assessment and physician global assessment to assess the clinical response.Results:In the microinjection group, there was 35.72% improvement in the MASI score compared to 44.41% in the microneedling group, at the end of third follow-up visit. Six patients (26.09%) in the microinjections group, as compared to 12 patients (41.38%) in the microneedling group, showed more than 50% improvement. However, there were no major adverse events observed in both the treatment groups.Conclusions:On the basis of these results, TA can be used as potentially a new, effective, safe and promising therapeutic agent in melasma. The medication is easily available and affordable. Better therapeutic response to treatment in the microneedling group could be attributed to the deeper and uniform delivery of the medication through microchannels created by microneedling.

Efficacy and Safety of Tranexamic Acid in Melasma: A Meta-analysis and Systematic Review

“…After excluding studies that did not meet criteria for inclusion in the analysis, 11 studies were deemed appropriate and were included for meta-analysis ( Fig. 1) (7,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Among the included studies we had 1 abstract and 1 poster material (15,17).…”

“…oral, topical and localized microinjections) have shown promising results (7,(9)(10)(11), there is a lack of support for its efficacy and safety in melasma due to the absence of sufficiently powered randomized controlled trials (RCTs). Through a systematic review of the literature, we aimed to investigate the effectiveness and safety of TA, alone, or as an adjuvant, in patients with melasma.…”

Objective and Self-Perceived Facial Skin Status Using Whitening Efficacy of Cosmetic Products on Taiwanese Women

“…In the present study, there were improvements not only in surface spot, wrinkles, texture and pores facial skin status, but also in self-perceived pigmented spots, rough complexion, red complexion, wrinkle and obvious pores facial skin problems after using whitening cosmetic products. It has recently been proposed that tranexamic acid is not only a synthetic antifibrinolytic agent but also a whitening ingredient in cosmetics [10] [20]. In addition, antioxidants are becoming increasingly important in whitening cosmetics according to their anti-inflammatory effects.…”

“…Examples for vitamin C derivatives and tranexamic acid in cosmetics products are skin-whitening lotions, creams, milky lotions, facial packs and scalp care cosmetics [9]. Sensitive detection and determination of tranexamic acid is thus of interest not only in cosmetics but also in clinical and pharmaceutical samples [10] [11].…”

Tranexamic for Treatment of Melasma

“…Plasmin activated precursors of secretory phospholipase A2, which participates in the production of arachidonic acid from membrane phospholipids. Arachidonic acid is a precursor to prostaglandins E2 and leukotrienes, which can subsequently lead to melanogenesis (Figure 2) [5,6].…”