Asmaa Ibrahim Tahoun

Cairo University

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Wedad Z. Mostafa

Tanta University

Marwa Ahmed Amer

Cairo University

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Cairo University

Tanta University

King Faisal University

Alfaisal University

King Faisal Specialist Hospital & Research Centre

Amer Sports (United States)

Zagazig University

University of Toledo Medical Center

Sinai University

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Dermoscopic evaluation of tranexamic acid versus Vitamin C, with microneedling in the treatment of melasma: a comparative, split-face, single-blinded study

Journal of Dermatological Treatment (2021)

Asmaa Ibrahim Tahoun Wedad Z. Mostafa Marwa Ahmed Amer

Melasma is a complex pigmentary disorder with challenging management.Evaluation of efficacy of topical tranexamic acid (TXA) versus Vitamin C (Vit C) with microneedling (MN) in melasma therapy.In 30 females with melasma, after 4 weeks of using Modified Kligman's formula, the right side of the face was treated with MN + TXA and the left with MN + Vit C for five biweekly sessions. Wood's light, dermoscopy, Melasma Area and Severity Index (MASI), MASI malar right and malar left (MASIMR and MASIML), Visual Analogue Score (VAS), and Dermatology Life Quality Index (DLQI) were evaluated at weeks 0, 4, 12, and 16.Both MASIMR and MASIML decreased significantly (p < .001). Both sides exhibited significant diminution in dark fine granules (p-value < .001), homogeneous pigmentation (p-value = .005) and pseudoreticular brown network (p-value = .028). However, telangiectasia significantly improved only on the TXA treated side (p = .002). DLQI improved significantly on both sides (p < .001). In some patients transformation of mixed to dermal melasma was depicted.MN followed by Vit C or TXA is successful in melasma management, the latter being advantageous vis-a-vis dermal vascularity and epidermal pigmentation. Dermoscopic evaluation appears crucial in choosing optimum treatment in each patient.

Melasma

10.1080/09546634.2021.1871582

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