Study of oral tranexamic acid, topical tranexamic acid, and modified Kligman's regimen in treatment of melasma

Abstract Background Melasma is a pigmentary disorder affecting mainly face . Various treatment modalities available as topicals, superficial chemical peels and lasers but none till date gives promising results, until date quest for the best treatment modality is on. Aim To study the effect of oral and topical Tranexamic acid (TXA) and modified Kligman’s regimen in treatment of melasma. Method Patients having melasma were enrolled after consent for voluntary participation. A detailed history and clinical examination was done. Total 60 patients were enrolled and randomized in three groups, 20 received oral TXA 250 mg twice daily, 20 topical TXA and 20 received modified Kligman’s regimen for 8 weeks along with sunscreen MASI(Melasma area severity index) was calculated at baseline, at end of 4 & 8 weeks. MASI score was compared with that at the end of the study. Based on reduction in mean MASI the therapeutic response was graded. Pre and post treatment photographs was also compared. Statistical analysis done by using student square T test , ANOVA And TUKEY test. Results Reduction in MASI score was observed in all the groups but greater reduction in MASI score with modified Kligman’s regimen by 30% followed with oral TXA by 25% reduction and least with topical TXA by 5%. Conclusion Although modified Kligman’s regimen is comparatively more efficient but due to its side effects in long term usage oral tranexamic acid could be a promising therapeutic approach for melasma.