Effectiveness of intra-lesional tranexamic acid in treatment of melasma
AbstractIntroduction Melasma is acquired hypermelanosis of skin. It mostly occurs on face involving the cheeks, temple and upper lip. Especially it is seen in people living in areas with intense ultraviolet radiations. It occurs mostly in ladies of childbearing age. The condition may likewise occur in men. This condition is increasingly common in women accounting for 90% of all cases. Objective The objective of this particular study is to determine the effectiveness of intralesional tranexamic acid in the treatment of melasma. Methods This Quasi-experimental study was carried out in Dermatology Department of Shaikh Zayed Hospital, Federal Postgraduate Medical Institute, Lahore from February 2018 to February 2019. One hundred seventy patients were enrolled for this study. Results The mean age of patients was 35.46±8.00 years. Out of 170 patients, 66 (39%) were males and 104 (61%) were females. Thus the female to male ratio was 1.57:1. The improvement after four weeks of treatment, 11 (7.0%) patients had excellent improvement and most of the patients i.e. 84 (49.0%) had good improvement, 66 (39.0%) had fair and 9 (5.0%) had poor response. After 8 weeks, 52 (31.0%) patients had excellent response, majority of patients 93 (55.0%) had good improvement, 21 (12.0%) had fair and 4 (2.0%) had poor improvement. The improvement after 12 weeks of treatment showed that 71 (41.8%) had excellent improvement, 67 (39.4%) had good, 30 (17.6%) had fair improvement and only 2 (1.2%) had poor improvement. The comparison of effectiveness after treatment of 4 and 8 weeks of treatment which is statistically significant p <0.05. The comparison for effectiveness after treatment of 4 and 12 weeks which is statistically significant p <0.05.The comparison of effectiveness after treatment for 8 and 12 weeks which is statistically not significant p 0.06. Conclusion We conclude that intralesional microinjection of TA appears to be a potentially new and promising therapeutic tool that can be easily performed in outpatient settings, and this treatment produces relatively rapid results without significant side effects. For this reason, it may be used as part of melasma treatments, especially for the dermal and mixed melasma. Larger studies will be needed to determine the optimal dosage, the injection frequency, the injection technique, long term benefits, and any potentially additional adverse effects.