Comparing the efficacy of Myjet‐assisted tranexamic acid and vitamin C in treating melasma: A split‐face controlled trial

Abstract

Melasma is an acquired, benign, and chronic hypermelanosis characterized by irregular light brown to dark brown patches of hyperpigmentation on the skin. Its prevalence varies according to ethnic background, skin phototype, and intensity of sun exposure. 1 The precise incidence of melasma remains unknown but both males and females can be affected in nearly every racial subgroup. Melasma is more common in darker skin types, particularly Fitzpatrick skin types III and IV, and often lasts for many years after pregnancy. 2 Melasma appears as light brown to dark, muddy brown macules and patches on the face, especially the forehead, malar areas, and chin, and it may last for decades, impacting on quality of life in those affected patients, such as emotional well-being and social life. 3 Interestingly, the negative effect on quality of life with melasma such as depression was not correlated with the severity of melasma, suggesting that even a small amount of pigmentation may have a significant emotional role. 2 The pathogenesis of melasma is complex, and its treatment remains challenging. While sun exposure, pregnancy and oral contraceptives are thought to be risk factors, much remains to be elucidated. 4 Therapeutic innovation for melasma remains a goal for dermatologists worldwide. There are many treatment options for melasma, including topical drugs, oral drugs, chemical peels, and laser and light treatments. 5

Efficacy and safety of tranexamic acid in the treatment of adult melasma: An updated meta‐analysis of randomized controlled trials

“…Among the 24 studies, 1383 patients were included. Eight studies [14][15][16][17][18][19][20][21] evaluated the efficacy and safety of oral TXA, four studies [22][23][24][25] evaluated the efficacy and safety of intradermal TXA, and twelve studies evaluated the efficacy and safety of topical TXA. 5,[26][27][28][29][30][31][32][33][34][35][36] In the study by Tawfic SO, 30 topical and intradermal TXA administration routes were adopted in the treatment arm; thus, the study was analysed separately.…”

“…We retrieved 86 studies from three databases, among which 24 studies published between 2013 and 2020 were finally eligible for inclusion 5,14–36 (Figure 1). Detailed information on the studies included is presented in Table 1.…”

The efficacy of oral vs different dilutions of intradermal tranexamic acid microinjections in melasma—A randomized clinical trial

“…4 Tranexamic acid (TXA) is a hemostatic drug which can bind to lysine residues of plasminogen and prevents its conversion to plasmin, furthermore, it can decrease the generation of arachidonic acid and α melanocyte stimulating hormone (α-MSH), resulting in reduction of pigment production in melanocyte. 5 TXA targets the vascular component in melasma suppressing angiogenesis induced by VEGF through plasmin inhibition. 6 Several forms of TXA, including oral, topical, and localized microinjection forms, have been shown to improve melasma.…”

Safety and efficacy of mesotherapy in the treatment of melasma: A review article

“…Over 60% improvement was achieved in 70.6% of the cases in both groups. Patients’ satisfactions in TXA and vitamin C mesotherapy groups were 64.7% and 58.8%, respectively 34 …”