Topical tranexamic acid versus hydroquinone for patients presenting with melasma

Objective To compare the outcome with topical tranexamic acid versus hydroquinone for management of patients presenting with melasma.   Methods The present study was conducted in the outpatient department of dermatology unit 1. 354 patients fulfilling selection criteria were enrolled and divided in two groups. In group A, patients were prescribed topical cream of 5% TA and in group B, patients were prescribed topical cream of 2% hydroquinone. MASI score was assessed at presentation and at 4 weeks of follow up.   Results In this study the mean age of cases in Tranexamic acid group was 35.42±10.68 years and in Hydroquinone group was 36.25 ±10.42 years. In Tranexamic acid there were 13(7.3%) male and 164(92.7%) female cases and in Hydroquinone group there were 26(14.7%) male and 151(85.3%) female cases. Mean duration of pigmentation in Tranexamic acid group was 6.45±3.10 months and in Hydroquinone group was 6.50±3.02 months. The mean MASI score at baseline in Tranexamic acid group was 36.14 ± 6.85 and in Hydroquinone group was 36.61 ± 6.81. The mean MASI score at last follow up in Tranexamic acid group was 23.68±7.96 and in Hydroquinone group was 19.32±8.33. The mean MASI score was statistically less in Hydroquinone group as compared to Tranexamic acid group, p-value < 0.01. In Tranexamic acid group 39(22%) cases had side effects and in Hydroquinone group 83(46.9%) cases had side effects.   Conclusion This study concludes that MASI score was significantly reduced in hydroquinone group but cases in topical tranexamic acid group developed less side effects. So, further studies are required to establish the use of topical tranexamic acid.