Comparing the efficacy of topical hydroquinone 2% versus intradermal tranexamic acid microinjections in treating melasma: a split-face controlled trial

Introduction: Melasma is a benign, acquired and chronic hypermelanosis. Topical hydroquinone (HQ) is a conventional choice to treat melasma. Tranexamic acid (TA) is a relatively new brightening agent that interferes with keratinocyte-melanocyte interactions. The aim of the present study was to compare the efficacy and safety of TA intradermal injections with HQ in treating melasma.Materials and methods: In this split-face controlled trial, 37 patients were randomized to receive three monthly sessions of TA intradermal injections either on the right or the left side of their face and topical HQ once a night for three months on the other side. Melanin and erythema were measured for each side of the face at the baseline and at the end of each month.Results: A reduction in melanin value was observed for TA and HQ separately (p value <.001). Monthly TA injection was better than daily HQ in reducing the melanin value during the first four weeks (p value =.013); but after 20 weeks, the overall changes was not different between the two groups (p value =.17).Conclusion: Monthly TA intradermal injections can be an effective treatment for melasma. Further studies are required to support our results.