Comparative study between topical tranexamic acid alone versus its combination with autologous platelet rich plasma for treatment of melasma

Background: Tranexamic acid is a promising drug for melasma treatment, but its topical formulation has limited efficacy. Its use as liposome based cream or in combination with other modalities might help to achieve better results. Objective: Comparing efficacy of topical tranexamic acid 5% in liposome base alone versus its combination with intradermal platelet rich plasma (PRP) for melisma treatment. Methods: Forty female patients with melasma were divided randomly into 2 equal groups who were treated with topical tranexamic acid 5% cream twice daily for 12 weeks and group B received additional intradermal injections of PRP every 3 weeks throughout the treatment period. Evaluation was done through modified MASI score and patient satisfaction after one month from the end of treatment. Results: Both groups showed significant improvement of modified MASI score after treatment. Significantly better treatment response and patient satisfaction were detected in patients of group B (p =.024,.029). The side effects of PRP were mild and tolerable and tranexamic acid was well tolerated. Conclusion: 5% topical tranexamic acid in liposome base is thought to be safe and effective modality for treatment of melasma. PRP is advisable as an autologous safe elixir which boosts the therapeutic effect of tranexamic acid.