Comparative Efficacy of Intralesional Tranexamic Acid and Platelets Rich Plasma (Prp) In The Treatment of Melasma
DOI:
https://doi.org/10.51253/pafmj.v76iSUPPL-6.10811Keywords:
Melasma, mMASI (modified Melasma Area and Severity Index), Platelets Rich Plasma (PRP), Tranexamic Acid.Abstract
Objective: To study the efficacy of intralesional tranexamic acid compared to platelets rich plasma (PRP) in treatment of melasma.
Study Design: Randomized Controlled Trial (ClinicalTrials.gov Identifier: NCT05884151).
Place and Duration of Study: Department of Dermatology, CMH (Combined Military Hospital) Abbottabad, from Nov 2022 to April 2023.
Methodology: Sample size of 60 patients, aged 20 to 40 years, was calculated by using OpenEpi online calculator. Informed consent was taken and patients were randomly allocated to two groups: Group A, where 30 patients were injected with intradermal tranexamic acid (4 mg/ml) and Group B, where 30 patients were treated with PRP (1 ml) intra-dermally, every fourth week, for up to 12 weeks between both groups. The modified Melasma Area and Severity Index (mMASI) was used to evaluate all patients. The final evaluation was performed on the 24th week of follow-up. For data analysis Statistical Package for the Social Sciences (SPSS) version 27.00 was used. To determine statistical significance, a paired t-samples test was used where p-value was <0.05.
Results: Of the 60 patients randomly assigned to two groups, Group A had mean age of 30.23+5.24 years while Group B had mean age of 29.50+5.83 years. The majority of patients were females 47(78.30%). Overall, 31(51.70%) patients had malar pattern of melasma (p-value=0.030) while 46(76.70%) patients had mixed melasma (p-value=0.015). While comparing pre-treatment efficacy, mMASI score in Group A was 1..
Conclusions: Tranexamic acid was found to be highly effective and safer than PRP with patient compliance being better due to no pain.
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References
in patients with melasma: risk factors and consequences. J Liaquat Uni Med Health Sci. 2020; 19(01): 6-11. https://doi.org/10.22442/jlumhs.201910652
2. Kaleem S, Ghafoor R, Khan S. Comparison of efficacy of tranexamic acid mesotherapy versus 0.9% normal saline for melasma: a split face study in a tertiary care hospital of Karachi. Pak J Med Sci. 2020; 36(5): 930-934.
https://doi.org/10.12669/pjms.36.5.2379
3. Hoque F, McGrath J, Shaude SE. Melasma (chloasma): pathogenesis and treatment. J Biotechnol Biomed. 2022; 5(4): 236-243.
https://doi.org/10.26502/jbb.2642-91280064
4. Rajanala S, Maymone MB, Vashi NA. Melasma pathogenesis: a review of the latest research, pathological findings, and investigational therapies. Dermatol Online J. 2019; 25(10). https://doi.org/10.5070/d32510045810
5. da Cunha MG, da Silva Urzedo AP. Melasma: a review about pathophysiology and treatment. Pigment Disord. 2022. https://doi.org/10.5772/intechopen.109005
6. Austin E, Nguyen JK, Jagdeo J. Topical treatments for melasma: a systematic review of randomized controlled trials. J Drugs Dermatol. 2019; 18(11): S1545961619P1156X. https://doi.org/10.36849/JDD.1156
7. Mahajan VK, Patil A, Blicharz L, Kassir M, Konnikov N, Gold MH, et al. Medical therapies for melasma. J Cosmet Dermatol. 2022; 21(9): 3707-3728.
https://doi.org/10.1111/jocd.15242
8. Garg S. Platelet rich plasma therapy, micro needling, and mesotherapy for the treatment of melasma. Melasma Monogr. 2021; 1: 103.
https://doi.org/10.1111/jocd.13157
9. Pazyar N, Molavi SN, Hosseinpour P, Hadibarhaghtalab M, Parvar SY, Dezfuly MB, et al. Efficacy of intradermal injection of tranexamic acid and ascorbic acid versus tranexamic acid and placebo in the treatment of melasma: a split-face comparative trial. Health Sci Rep. 2022; 5(2): e537. https://doi.org/10.1002/hsr2.537
10. Tuknayat A, Bhalla M, Thami GP. Platelet-rich plasma is a promising therapy for melasma. J Cosmet Dermatol. 2021; 20(8): 2431-2436.
https://doi.org/10.1111/jocd.14229
11. Patil NK, Bubna AK. A comparative evaluation of the efficacy of intralesional tranexamic acid versus platelet rich plasma in the treatment of melasma. Dermatol Ther. 2022; 35(5): e15534.
https://doi.org/10.1111/dth.15534
12. Pazyar N, Yaghoobi R, Zeynalie M, Vala S. Comparison of the efficacy of intradermal injected tranexamic acid vs hydroquinone cream in the treatment of melasma. Clin Cosmet Investig Dermatol. 2019; 12: 115-122.
https://doi.org/10.2147/CCID.S191964
13. Konisky H, Balazic E, Jaller JA, Khanna U, Kobets K. Tranexamic acid in melasma: a focused review on drug administration routes. J Cosmet Dermatol. 2023; 22(1): 48-55.
https://doi.org/10.1111/jocd.15589
14. Ali R, Aman S, Nadeem M, Kazmi AH. Quality of life in patients of melasma. J Pak Assoc Dermatologists. 2013; 23(2): 143-148.
15. Ogbechie-Godec OA, Elbuluk N. Melasma: an up-to-date comprehensive review. Dermatol Ther (Heidelb). 2017; 7(3): 305-318.
https://doi.org/10.1007/s13555-017-0194-1
16. Thappa DM. Melasma (chloasma): a review with current treatment options. Indian J Dermatol. 2004; 49:165-176.
17. Gharib K, Mostafa FF, Ghonemy S. Therapeutic effect of microneedling with platelet-rich plasma versus microneedling with tranexamic acid for melasma. J Clin Aesthet Dermatol. 2021;14(8):44-48.
18. Ebrahim HM, Said Abdelshafy A, Khattab F, Gharib K. Tranexamic acid for melasma treatment: a split-face study. Dermatol Surg. 2020;46(11): e102-e7.
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