Efficacy of topical silymarin and intradermal injection of tranexamic acid in the treatment of melasma: A comparative study

Authors

  • Anum Naveed Department of Dermatology, PGMI/ Lahore General Hospital, Lahore, Pakistan
  • Kehkshan Tahir Department of Dermatology, Fatima Jinnah Medical University/ Sir Ganga Ram Hospital, Lahore
  • Fatima Bashir Department of Dermatology, Azra Naheed Medical College/ Chaudhry Muhammad Akram Teaching & Research Hospital, Lahore
  • Ghazia Shaheen Department of Dermatology, PGMI/ Lahore General Hospital, Lahore, Pakistan.
  • Memoona Tahir Department of Dermatology, AMC/ PGMI/ Lahore General Hospital, Lahore
  • Ayesha Shafqat Department of Dermatology, AMC/ PGMI/ Lahore General Hospital, Lahore

Keywords:

Tranexamic acid, Intradermal injection, Silymarin cream, Melasma, mMASI

Abstract

Background Melasma is a disorder of pigmentation that results from hypermelanosis. Despite numerous treatment options, response is variable, unsatisfactory, requires prolong course and mostly refractory to available treatments. There is lack of local study and limited international data about silymarin. Intralesional tranexamic acid is now a days an emerging therapeutic tool for melasma.   Objective To compare the efficacy of topical silymarin versus intradermal injection of tranexamic acid in patients of melasma.   Methods Total 72 patients were taken and divided randomly into two equal groups. Group A applied silymarin cream 1.4% two times daily for total 12 weeks on affected areas and group B was given intradermal injections of tranexamic acid 4mg/ml in affected areas at 1cm interval, every week for total 12 weeks. Efficacy was labeled as >50% reduction in modified Melasma Area and Severity Index score from baseline at 12th week.   Results Mean age of the patients was 30.29±7.68 years, 16 (22.22%) were male and 56 (77.78%) were females. Efficacy in Group A was seen in 16 (44.44%) patients and in Group B efficacy was seen in 25(69.4%) patients (p-value=0.03).   Conclusion Intradermal injection of tranexamic acid is more effective as compared to topical Silymarin cream in the treatment of melasma.  

Author Biographies

Anum Naveed, Department of Dermatology, PGMI/ Lahore General Hospital, Lahore, Pakistan

Postgraduate Resident

Kehkshan Tahir, Department of Dermatology, Fatima Jinnah Medical University/ Sir Ganga Ram Hospital, Lahore

Associate Professor

Fatima Bashir, Department of Dermatology, Azra Naheed Medical College/ Chaudhry Muhammad Akram Teaching & Research Hospital, Lahore

Senior Registrar Department of Dermatology

Ghazia Shaheen, Department of Dermatology, PGMI/ Lahore General Hospital, Lahore, Pakistan.

Postgraduate Resident

Memoona Tahir, Department of Dermatology, AMC/ PGMI/ Lahore General Hospital, Lahore

Postgraduate Resident

Ayesha Shafqat, Department of Dermatology, AMC/ PGMI/ Lahore General Hospital, Lahore

Postgraduate Resident

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Published

2024-12-31

How to Cite

1.
Naveed A, Tahir K, Bashir F, Shaheen G, Memoona Tahir, Shafqat A. Efficacy of topical silymarin and intradermal injection of tranexamic acid in the treatment of melasma: A comparative study. J Pak Assoc Dermatol [Internet]. 2024Dec.31 [cited 2025Feb.16];34(4 Suppl.):S1-S7. Available from: https://jpad.com.pk/index.php/jpad/article/view/2794

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