Efficacy of microneedling with platelet-rich plasma versus microneedling with tranexamic acid in melasma – A randomized open-label study

Objectives Melasma is a recalcitrant hyperpigmentary disorder requiring innovative treatment options for its management. The objectives of the study are to compare the efficacy of microneedling with platelet-rich plasma (PRP) versus microneedling with tranexamic acid (TXA) in melasma in terms of Modified Melasma Area and Severity Index Score (mMASI), Physician Assessment Score (PAS), and Patient Satisfaction Score (PSS) among them. Material and Methods This was a randomized open-label study in which 50 cases of melasma (18–60 years) were included. Patients were randomly allocated into 2 groups of 25 patients each. Group 1 was treated with microneedling with PRP and group 2 with microneedling with TXA for three sessions every 3 weeks, and were followed up till 15 weeks. Results Mean mMASI decreased significantly from 7.14 to 3.88 and 7.65 to 4.24 in groups 1 and 2, respectively, from baseline to 15 weeks ( P < 0.001) and statistically significantly between the 2 groups ( P = 0.043). However, no significant difference was found between PAS and PSS between them. Conclusion Microneedling was found to be effective with both PRP and TXA in melasma. However, microneedling with PRP demonstrated greater efficacy versus TXA. Hence, it can be considered a promising treatment modality in the future.