Efficacy of Intradermal Tranexamic acid versus topical 5% Magnesium ascorbyl phosphate in the treatment of melasma: A head-to-head comparison

Abstract

Background Melasma is a chronic skin hyperpigmentation disorder involving 50–70% of people worldwide, mostly women of childbearing age. Various treatment modalities are available, but no previous study has undergone a head-to-head comparison of intradermal tranexamic acid (TXA) and topical magnesium ascorbyl phosphate (MAP) to treat melasma. This study aimed to fill this research gap.   Objective To compare effectiveness of intradermal (TXA) and topical (MAP) in the treatment of melasma.   Methods A total of 128 patients were enrolled, 64 in each group. Patients were divided into groups A and B using randomization technique, and their melasma severity index score (MASI) was calculated. Patients in group A were treated with four cycles of intradermal TXA at weeks 0, 4, 8, and 12. Group B was treated with topical MAP cream once a day for 12 weeks. At the end of 12 weeks, efficacy was assessed by calculating the MASI score.   Results The mean age in the injected TXA group (A) was 39.4±7.9 years and 37.5±8.3 years in the MAP group (B). In the group-wise distribution of gender, 20.3% of males and 79.7% of females were enrolled in group A, while 17.1% of males and 82.9% of females were included in group B. Baseline MASI scores for groups A and B were 16.7±5.4 and 16.06±6.15, respectively. At the end of 12 weeks, the efficacy of injected TXA was noted as being 54.7%, while 78.1% effectiveness was noted in the MAP group (P- value=0.005).   Conclusion It has been concluded that topical MAP is better than intradermal TXA for the treatment of melisma.