Comparison of Efficacy of Mesotherapy with Tranexamic Acid versus Ascorbic Acid in the Treatment of Melasma: A Split-Face Comparative Study
DOI:
https://doi.org/10.51985/Keywords:
Ascorbic Acid; Melasma; Mesotherapy; Skin Pigmentation; Tranexamic AcidAbstract
Abstract
Objectives: To compare the efficacy and safety of intradermal mesotherapy with tranexamic acid (TA) and ascorbic acid (AA) in patients with facial melasma.
Study Design and Setting: A quasi-experimental split-face comparative study was conducted at the Department of Dermatology, Tertiary Care Hospital, Malir Cantt, Karachi, over a period of six months after approval of the research protocol by the institutional review authority.
Methodology: Sixty patients aged 20–50 years with bilateral facial melasma were enrolled through non-probability consecutive sampling. Intradermal tranexamic acid (100 mg/mL) was administered on the right side of the face, while ascorbic acid (20%) was injected on the left side at two-week intervals for 12 weeks. Treatment response was assessed using the modified Melasma Area and Severity Index (mMASI) score at baseline and follow-up visits. Adverse effects were also recorded.
Results: Both treatment modalities showed significant reduction in mMASI scores after 12 weeks. However, the TA-treated side demonstrated a significantly greater mean reduction in mMASI score compared to the AA-treated side (73.9% ± 11.6 vs. 57.5% ± 13.2; p<0.001). Excellent response (=75% improvement) was observed in 56.7% of TA-treated sides compared to 30% of AA-treated sides. Adverse effects including erythema, burning sensation, and pain at injection site were mild and transient in both groups.
Conclusions: Intradermal mesotherapy with tranexamic acid was more effective than ascorbic acid in reducing the severity of melasma while maintaining a comparable safety profile. Both treatments were well tolerated; however, tranexamic acid produced faster and greater pigment reduction, particularly in patients with darker skin phototypes
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