Effect of Intense Pulsed Light versus Intradermal Tranexamic Acid for the Management of Melasma

J Coll Physicians Surg Pak. 2024 May;34(5):522-526. doi: 10.29271/jcpsp.2024.05.522.

Abstract

Objective: To compare the effectiveness of intense pulsed light (IPL) and intradermal tranexamic acid (TXA) in treating melasma.

Study design: A cross-sectional analytical study. Place and Duration of the Study: Department of Dermatology, Dow International Medical College, Dow University Hospital, Karachi, Pakistan, from 15th January to 15th July 2023.

Methodology: A total of 62 patients with melasma, aged 20-50 years, were divided into two groups. Group A (32 patients) received IPL (560 nm filter was used) treatment, and Group B (30 patients) received intradermal TXA. Each group underwent four treatment sessions with varying intervals. Melasma area and severity index (MASI) scores were used to compare the effects of treatment.

Results: After a 3-month treatment period, both groups showed reduced mMASI scores compared to baseline with a significant initial difference between Group A (8.6 ± 4.2) and Group B (5.4 ± 2.7, p <0.001). However, post-treatment, there was no significant difference in mMASI scores (Group A: 3.8 ± 2.6; Group B: 3.2 ± 2.0, p = 0.29). IPL treatment (Group A) demonstrated a significant reduction in mMASI scores (57.1 ± 19.7) compared to intradermal TXA treatment (Group B, 42.2 ± 18.8, p = 0.0034).

Conclusion: Both IPL and intradermal TXA treatments effectively reduced melasma, with IPL exhibiting superior results. However, post-treatment outcomes converged, emphasising the need for personalised approaches considering the unique characteristics of South East Asian skin.

Key words: Intense pulsed light, Melasma, Intradermal tranexamic acid.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Antifibrinolytic Agents / administration & dosage
  • Antifibrinolytic Agents / therapeutic use
  • Cross-Sectional Studies
  • Female
  • Humans
  • Injections, Intradermal
  • Intense Pulsed Light Therapy* / methods
  • Male
  • Melanosis* / drug therapy
  • Melanosis* / therapy
  • Middle Aged
  • Pakistan
  • Severity of Illness Index
  • Tranexamic Acid* / administration & dosage
  • Tranexamic Acid* / therapeutic use
  • Treatment Outcome
  • Young Adult

Substances

  • Tranexamic Acid
  • Antifibrinolytic Agents