EFFICACY OF INTRADERMAL MICRO INJECTION OF TRANEXAMIC ACID VS ORAL TRANEXAMIC ACID FOR THE TREATMENT OF MELASMA

Background: Melasma is a common acquired hyperpigmentation disorder that significantly affects quality of life. Tranexamic acid (TXA) has recently emerged as a promising therapeutic option, administered via different routes including oral and intradermal delivery. However, comparative evidence regarding their relative efficacy remains limited. Objective: To compare the efficacy of intradermal microinjection of tranexamic acid with oral tranexamic acid in the treatment of melasma. Study Design: A randomized controlled trial. Setting: Department of Dermatology, Combined Military Hospital, Nowshera, Pakistan. Duration of Study: 11-October-2024 to 11-April-2025. Methods: A total of 62 patients with clinically diagnosed melasma were enrolled and allocated equally into two groups. Group A received intradermal TXA microinjections at three-week intervals for five sessions, while Group B received oral TXA 250 mg twice daily for 12 weeks. The primary outcome was the proportion of patients achieving treatment efficacy, assessed by [insert scale used, e.g., MASI reduction if available]. Statistical analysis was performed using the Chi-square test, with a p-value of ≤ 0.05 considered statistically significant. Results: The mean age in Group A was 31.61 ± 11.37 years and in Group B 31.48 ± 10.94 years. A significantly higher proportion of patients in the intradermal TXA group achieved efficacy (64.5%, n = 20) compared with the oral TXA group (29.0%, n = 9) (p = 0.005). Conclusion: Intradermal tranexamic acid microinjections demonstrated significantly superior efficacy compared to oral tranexamic acid in the treatment of melasma. These findings suggest that intradermal administration may be the preferred therapeutic option for achieving optimal clinical outcomes.