Topical Ascorbic Acid Mesotherapy with Microneedling versus Topical Tranexamic Acid Mesotherapy with Microneedling for Melasma: A Therapeutic Comparative Study

Background & objectives: Melasma is a common skin hyperpigmentation syndrome that frequently includes reproductive-aged females, and numerous therapies with various consequences have been suggested. Thus, the objective was to compare the microneedling and mesotherapeutic effects of ascorbic acid versus tranexamic acid for melasma treatments. Methods: This interventional therapeutic prospective study was conducted on 40 patients with melasma at Khabat Consultation Center for Skin Diseases, Sulaimaniyah, Iraq, from March 2022 to August 2022. Sociodemographic data of patients were collected together with a family history of melasma using a well-designed questionnaire. Half of the patients were treated with ascorbic acid, while the rest were treated with tranexamic acid using a derma pen. Results: Highly significant reduction of MASI score were seen before and after treatment (p<0.001) were seen in mean scores before and after treatments for both types of treatments (ascorbic acid and tranexamic acid). Moreover, ascorbic acid results in the highest mean score reduction in skin type III (p=0.746), while tranexamic acid results in the highest mean score in skin type IV (p<0.05). Furthermore, the dermal melasma recorded the highest mean score, and the lowest level was observed in the epidermal melasma for both ascorbic acid and tranexamic acid groups. No significant difference was found between both studied groups in sociodemographic data and other studied variables (family history, skin type, previous treatment, and duration of melasma). Conclusions: Both types of therapy mesotherapy was effective in treating melasma; however, their potencies varied on different skin types and according to melasma types.