Intradermal injection of tranexamic acid combined with topical hydroquinone cream versus topical hydroquinone cream alone in the treatment of melasma

Background: Melasma is a common acquired skin disorder that presents as abilateral, blotchy, brownish facialpigmentation due to a dysfunction in melanogenesis. It is most common in people who tans easily or have naturally brown skin (Fitzpatricks skin phototypesIII, IV).Although several treatments are currently used, it remains a great challenge.Aim: This study aims to compare the efficacy of intradermal injection of tranexamic acid (TA) combined with topical hydroquinone cream versus hydroquinone (HQ) cream in the treatment of melasma.Materials and Methods: In thisinterventional prospective comparative clinical trial study, 31 patients with facial melasma were divided randomly into 2 groups, A (16 patients) and B (15 patients). Group A received the combination treatment of intralesional tranexamic acid and topical hydroquinone cream, while group B received topical hydroquinone cream alone. Both groups were assessed by MASI score at baseline and weeks 2, 4, 6, and 8.Results: Thirty-one patients (16 in group A and 15 in group B) completed the study. According to the decline in MASI score, the combination of tranexamic acid and hydroquinone was more effective than hydroquinone alone in the treatment of melasma.Conclusion: Injection of TA intradermally combined with topical HQ cream can be an effective treatment for melasma.