Efficacy of microneedling plus topical 4% tranexamic acid solution vs 4% hydroquinone in the treatment of melasma: A single‐blind randomized clinical trial

Abstract

Background There are various treatment modalities for melasma, but none of them are effective on dermal component of melasma. Aims In this study, we decided to evaluate the efficacy of microneedling plus tranexamic acid in comparison with 4% hydroquinone in the treatment of melasma. Methods This is a single‐blind randomized clinical trial on 70 participants with 14% dropout, and therefore, 60 patients with melasma completed the study. Patients were randomized based on simple randomization in 2 groups of A (microneedling plus topical 4% tranexamic acid, monthly) and B (topical 4% hydroquinone, nightly). Evaluation of mean MASI score, patient and physician assessments was performed at 4th, 8th and12th weeks of the treatment. Statistical analysis was performed by paired t test, chi‐square test and Fisher's exact test, respectively. Results Sixty women (30 patients in each group) were completed the study. Mean MASI score in group A was significantly lower at the end of the treatment (6.84 ± 4.31) than at the baseline (12.89 ± 5.16) (P < .01). Mean MASI score in group B was significantly lower at the end of the treatment (7.16 ± 4.38) than at the baseline (13.56 ± 4.88) (P < .01). There was no statistical difference between 2 groups regarding MASI score, physician and patient assessments during the treatment. Percentage of patient satisfaction was significantly higher than physician satisfaction in both treatment groups (P < .01). Conclusion In our study, the combination of microneedling with tranexamic acid did not differ from 4% hydroquinone in the treatment of melasma.

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

“…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.…”

Microneedling‐assisted topical tranexamic acid solution versus 4% hydroquinone for treating melasma: A split‐face randomized study

“…12 Another recent study, the combination of microneedling with tranexamic acid did not differ from 4% hydroquinone in the treatment of melasma. 13 Topical TA (2%-3% solution) when used to ultraviolet exposed skin of guinea pigs prevented the pigmentation process compared to other areas where a vehicle control solution was applied.…”

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

“…ID microinjection of lightening drugs crosses skin barrier and results in better effectiveness on dermal pigmentation. Furthermore, higher concentration of drug in target area can be achieved with lower volumes, while having lower local side effects and prolonged efficacy 3–6 . In this review, we evaluated efficacy and safety of various types of mesotherapy for treating melasma.…”

“…Furthermore, higher concentration of drug in target area can be achieved with lower volumes, while having lower local side effects and prolonged efficacy. [3][4][5][6] In this review, we evaluated efficacy and safety of various types of mesotherapy for treating melasma.…”