Original Research Article
Year: 2019 | Month: January-March | Volume: 4 | Issue: 1 | Pages: 99-106
Study on Effectiveness and Safety of Combination of Daily 10% Tranexamic Acid Gel Application and Weekly Iontophoresis Versus Daily 10% Tranexamic Acid Gel Alone in Treatment of Melasma
Dr. Riddhi Arora1, Dr. Ramesh Sharma2
1Senior Resident, Dept. of Dermatology, Chandulal Chandrakar Medical College & Hospital, Kachandur, Durg, Chhattisgarh
2Professor (Skin and DVD), Dept. of Dermatology, LataMangeshkar Hospital, NKPSIMS, Nagpur
ABSTRACT
Objectives of the study: To compare the effectiveness of the combination of daily 10% tranexamic acid gel application and weekly iontophoresis versus daily 10% tranexamic acid gel alone (randomized split-face study) in the treatment of melasma and to compare the safety of the combination of daily 10% tranexamic acid gel application and weekly iontophoresis versus daily 10% tranexamic acid gel alone (randomized split-face study) in the treatment of melasma.
Materials and Methods: A prospective, randomized and evaluator blind split face study was conducted at tertiary care center. The study population was included patients presenting with melasma to Dermatology out-patient (OPD) of tertiary care center. Inclusion criteria: Patients willing to participate in the study, age more than 18 years and newly diagnosed untreated cases of Melasma were included in the study. After getting approval from the ethical committee, written informed consent was obtained from all participants before enrolment, procedures were explained and patients were acknowledged about all potential risks, benefits and side effects.
Masi Score: A subjective measurement based on the area and severity of the hyperpigmentation determined by Kimbrough-Green et al. was used for clinical assessment.
Results: All the participants were followed at weekly intervals till 12 weeks. The primary parameters considered to assess the efficacy of the treatment were area of the melasma and the darkness of melasma, both were graded on a scale of 1 to 4. As per the study findings, the iontophoresis combination treatment has resulted in reduction in the area of the melasma early at about 5 weeks, as compared to topical tranexamic acid alone, which has resulted in area of the melasma only after 7thweek of treatment. However, there was only marginal reduction in the area.
Conclusion: The most common type of melasma was type 1 melasma as seen in 80.00% of patients. The combined therapy resulted in faster reduction in the size of the melasma, but the reduction in size is comparable between both treatment groups as the time progresses. Both therapies achieved statistically significant reduction in area and darkness. However, this response was slight. Results obtained with modalities were comparable and no therapy was superior than other in this split face randomized trial. Both topical TXA and topical TXA plus iontophoresis therapy was well tolerated and were found to be safe.
Key words: tranexamic acid, melasma, iontophoresis, hyperpigmentation, combination treatment