Comparison Study Between Chemical Peeling with 70% Glycolic Acid and Intradermal Tranexamic Acid for the Treatment of Melasma
DOI:
https://doi.org/10.51253/pafmj.v74i2.8565Keywords:
70% Glycolic Acid, melisma, mMASI (modified Melasma Area and Severity Index), Tranexamic acid (TXA)Abstract
Objective: To compare the efficacy of 70% Glycolic acid peeling with Tranexamic acid mesotherapy in treating melasma.
Study Design: Quasi-experimental study
Place and Duration of Study: Department of Dermatology, CMH-Abbottabad Pakistan, Jun to Nov 2021.
Methodology: The 54 patients aged 20-50 years were enrolled and randomly assigned into two groups. In Group-A, 27 patients prescribed 70% Glycolic acid every two weeks for 12 weeks (6 sessions) and in Group-B, 27 patients injected every week for 12 weeks (12 sessions) with Intradermal Tranexamic acid (4mg/ml). All patients had a clinical examination using the mMASI scale. On follow-up, evaluation was carried out on the 1st, sixth, and 12th weeks.
Results: The majority of 35(65%) patients had mild MASI scores. The paired t-test results of Group A and Group B were both significant, while the post-treatment mean of Group A and B was insignificant.
Conclusion: The study concludes that Glycolic acid and TXA are equally efficient in treating melasma. Moreover, Tranexamic acid reduced the recurrence of melasma, but topical application of Glycolic acid showed more compliance.
Downloads
References
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%2Fpjms.36.5.2379
Shams N, Zeeshan S, Niaz F, Khan MA, Islam NU, Seetlani NK,
et al. Self-Medication in Patients with Melasma: Risk Factors and
Consequences. J Liaquat Uni Med Health Sci 2020; 19(01): 06-11.
Babbush KM, Babbush RA, Khachemoune A. The Therapeutic
Use of Antioxidants for Melasma. J Drugs Dermatol 2020; 19(8):
-792. https://doi.org/10.36849/jdd.2020.5079
Martin M, Hameedullah A, Priya MS. Unveiling the risk factors
behind melasma: An observational study. Int Arch Med. 2017;
(11): 85-89.
Dayal S, Sahu P, Dua R. Combination of glycolic acid peel and
topical 20% azelaic acid cream in melasma patients: efficacy and
improvement in quality of life. J Cosmet Dermatol 2017; 16(1):
-42.
https://doi.org/10.1111/jocd.12260
Tehranchinia Z, Saghi B, Rahimi H. Evaluation of therapeutic
efficacy and safety of tranexamic acid local infiltration in
combination with topical 4% hydroquinone cream compared to
topical 4% hydroquinone cream alone in patients with melasma:
a split-face study. Dermatol Res Pract 2018: 2018: 8350317.
https://doi.org/10.1155/2018/8350317
Taraz M, Niknam S, Ehsani AH. Tranexamic acid in the
treatment of melasma: A comprehensive review of clinical
studies. Dermatol Ther 2017; 30(3).
https://doi.org/10.1111/dth.12465
Elfar NN, El-Maghraby GM. Efficacy of intradermal injection of
tranexamic acid, topical silymarin and glycolic acid peeling in
treatment of melasma: a comparative study. J Clin Exp Dermatol
Res 2015; 6(280). https://doi.org/10.4172/2155-9554.1000280
Kaushik KU, Sachan S, Mohammad A. Study of efficacy of
intradermal injection of tranexamic acid and 50% glycolic acid
peeling in treatment of melasma. Int J Sci Stud 2018; 5: 58-60.
Parikh D, Naik PP. A Prospective, Interventional Study of Oral
Tranexamic Acid With Antioxidants and Local Glycolic Acid for
The Treatment of Resistant Melasma. J Dermatol Res Rev Rep
; 132: 2-4. https://doi.org/10.47363/JDMRS/2021
Ilknur T, Biçak MÜ, Demirtaşoğlu M, Özkan Ş. Glycolic acid
peels versus amino fruit acid peels in the treatment of melasma.
Dermatol Surg 2010; 36(4): 490-495.
Tse TW, Hui E. Tranexamic acid: an important adjuvant in the
treatment of melasma. J Cosmet Dermatol 2013; 12(1): 57-66
Sahu PJ, Singh AL, Kulkarni S, Madke B, Saoji V, Jawade S. et al.
Study of oral tranexamic acid, topical tranexamic acid, and
modified Kligman's regimen in treatment of melasma. J Cosmet
Dermatol 2020; 19(6): 1456-1462.
https://doi.org/10.1111/jocd.13430
Tan AWM, Sen P, Chua SH, Goh BK. Oral tranexamic acid
lightens refractory melasma. Australas J Dermatol 2017; 58(3):
e105-e108. https://doi.org/10.1111/ajd.12474
Tang SC, Yang JH. Dual effects of alpha-hydroxy acids on the
skin. Molecules 2018; 23(4): 863.
https://doi.org/10.3390%2Fmolecules23040863
Gupta RR, Mahajan BB, Garg G. Chemical peeling-Evaluation of
glycolic acid in varying concentrations and time intervals.
Indian J Dermatol Venereol Leprol 2001; 67(1): 28.
Rendon MI, Berson DS, Cohen JL, Roberts WE, Starker I, Wang
B. et al. Evidence and considerations in the application of
chemical peels in skin disorders and aesthetic resurfacing. J Clin
Aesthet Dermatol 2010; 3(7): 32-43.
Javaheri SM, Handa S, Kaur I, Kumar B. Safety and efficacy of
glycolic acid facial peel in Indian women with melasma. Int J
Dermatol 2001; 40(5): 354-357.