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).
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).
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.
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.