Open AccessOriginal Article Tranexamic Acid Mesotherapy Versus Triple Combination Cream in Melisma

Objective: To compare the efficacy of Tranexamic acid mesotherapy versus combination of hydroquinone, tretinoin, and fluocinolone cream (Triple cream) for melisma. Study Design: Randomized controlled trial (Iranian Registry of Clinical Trials = 20210823052264N1) Place and Duration of Study: Department of Dermatology, PNS Shifa Hospital Karachi, Pakistan from Mar 2022 to Aug 2022. Methodology: A total of 58 patients were divided randomly into two groups, A (29 patients) and B (29 patients). Group A patients received sessions of intalesional tranexamic acid 50mg/ml every 2 weeks. Group B patients were treated once nightly with Triple combination cream. Total Period of treatment was for twelve weeks for each patient. Measurement of Melasma Area Severity Index (MASI) Scores for both groups were calculated at 0, 4, 8, and 12 weeks. Final response was labelled at 12 weeks by comparing mean MASI reduction in both groups. SPSS, version 28 was used for data analysis and p<0.05 was considered significant. Results: At the end of study comparison was made of Mean reduction of MASI Score for both groups, significant reduction was noted in mean score from 7.73±1.43 to 4.30±1.34 (44.37%) in group A Tranexamic acid as compared to decrease in scores in group B Triple combination cream from 7.90±1.11 to 5.20±1.39 (34.18%) p-value 0.081. Conclusion: Tranexamic acid mesotherapy can be safe, effective and promising treatment option for melasma. It leads to better results, and lesser side effects than topical triple cream.