[Melasma] Microneedling-assisted Tranexamic Acid 4% vs. HQ 4%

The MASI score of the tranexamic acid + microneedling side changed from 6.348 ± 3.84 to 3.712 ± 1.19 with mean decrease percentage of 57.4% ± 23.4%.

Microneedling-assisted tranexamic acid 4% vs. topical hydroquinone 4% for melasma.
Microneedling-assisted tranexamic acid 4% vs. topical hydroquinone 4% for melasma.

Both hydroquinone (HQ) 4% and microneedling-assisted delivery of tranexamic acid (TA) 4% significantly improve melasma; but hydroquinone (HQ) shows slightly higher rates of patient satisfaction, according to the outcomes of a study published in the Journal of Cosmetic Dermatology (September 15, 2021).

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Mohamed S. Zaky MD, et al, performed a split-face study that included 50 subjects with melasma. They were randomized to receive topical 4% HQ (nightly application) and (microneedling + topical 4% TA, every other week).

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After eight weeks of treatment, the mean modified MASI score of the HQ-treated side changed from 6.604 ± 4.02 to 3.032 ± 1.19 with a mean decrease percentage of 54.8% ± 19.4%. The MASI score of the TA + microneedling side changed from 6.348 ± 3.84 to 3.712 ± 1.19 with mean decrease percentage of 57.4% ± 23.4%. Both reductions in modified MASI score were found to be statistically significant.

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Both treatments were also shown to be safe with minimal side effects. However, the topical HQ application achieved minimal, nonsignificant higher satisfactory results among both the raters and subjects.

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