Comparative evaluation of intralesional platelet rich plasma versus tranexamic acid (50mg/ml) in the treatment of facial melasma

: Melasma is a recalcitrant hyperpigmentary condition. The pathogenesis of melasma is complex and not fully understood. Although many treatment modalities have been tried for melasma but no modality is considered as gold standard. : This study aimed to compare efficacy of intralesional platelet rich plasma with tranexamic acid (50mg/ml) in the treatment of facial melasma. : Total 64 patients were enrolled in the current study from July 2023 to March 2024. In group A, 31 patients were treated with intralesional PRP and in group B, 33 patients were treated with intralesional TXA (50mg/ml). Intralesional injections were given every 4 weekly till lesions resolve or a maximum of 6 sessions followed by monthly follow up for 3 months. Grade of clinical improvement was measured by percentage reduction in mMASI score at baseline, at every session and at follow up. Patient satisfaction score was assessed using a five-point Likert scale at the end of the study. : In the PRP group, 64.52% patients showed moderate to good response whereas in the TXA group, 72.72% patients showed good to very good response. Only 41.94% patients were satisfied in group A while 81.81% patients were satisfied with their recovery after treatment in group B. : TXA was effective in all types of melasma. PRP was significantly effective only in female patients whereas TXA was significantly effecacious in both male and female patients. We suggest monthly therapy with intralesional TXA at a higher dosage of 50 mg/ml as an efficient and time-saving treatment modality over intralesional PRP.