Patients with dermal melasma benefit from combination treatment with microneedling plus topical application of 4% tranexamic acid, according to a randomized study published in the November 2020 issue of the Journal of Cosmetic Dermatology.
Authors Simin Shamsi Meymandi, MD, et al, of Kerman University of Medical Sciences, Kerman, Iran, evaluated the efficacy of microneedling plus tranexamic acid in comparison with 4% hydroquinone in the treatment of melasma. They treated 70 patients with melasma (60 patients completed the study), who were randomized based on simple randomization into two groups. Group A (30 patients) underwent monthly microneedling plus topical 4% tranexamic acid. Group B (30 patients) applied a topical 4% hydroquinone product nightly. The researchers evaluated melasma area severity and index (MASI) scores and patient satisfaction at baseline, four weeks, eight weeks and 12 weeks.
At the end of treatment, the mean MASI score was significantly lower in both groups with no statistical difference between two groups. Mean MASI score in group A was significantly lower at the end of the treatment (6.84 ± 4.31) than at the baseline (12.89 ± 5.16). Mean MASI score in group B was significantly lower at the end of the treatment (7.16 ± 4.38) than at the baseline (13.56 ± 4.88). The percentage of patient satisfaction was significantly higher than physician satisfaction in both treatment groups.