All authors are affiliated with the Dermatology, Venereology, and Andrology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Dermatol Surg. 2020 Nov;46(11):e102-e107. doi: 10.1097/DSS.0000000000002449.
Melasma is an acquired hyperpigmented skin disorder. Tranexamic acid (TXA) prevents ultraviolet radiation induced pigmentation in melasma through interfering with the plasminogen-plasmin pathway.
This study was conducted to evaluate the therapeutic effect and safety of TXA by intradermal injection versus TXA with microneedling for melasma treatment.
Fifty-six female patients with bilateral symmetrical melasma were recruited in a split-face study. All patients received an intradermal injection of TXA on one side of the face, and the other side received TXA with microneedling for 6 sessions at 2 weeks intervals. Clinical efficacy was assessed using a modified Melasma Area Severity Index (mMASI) score at the baseline and after treatment. Global photographs underwent blinded review by 2 dermatologists. Patient self-assessment and satisfaction were recorded.
After the treatment, the mMASI score was significantly reduced compared with the baseline in both treated sides (p < .001). No significant difference between both treated sides (p > .05). Patient satisfaction was higher in the microneedling-treated side than the intradermal-injected side (p < .001). No significant adverse effects were observed in both treated sides.
Intradermal injection and microneedling of TXA could be safe and effective in melasma treatment. Microneedling of TXA was significantly more satisfying to the patients.
黄褐斑是一种获得性色素沉着性皮肤病。氨甲环酸（TXA）通过干扰纤溶酶原-纤溶酶途径，防止紫外线诱导的黄褐斑色素沉着。
本研究旨在评估氨甲环酸皮内注射与微针联合氨甲环酸治疗黄褐斑的疗效和安全性。
56 例女性双侧对称性黄褐斑患者进行了一项分割面部研究。所有患者在一侧面部接受氨甲环酸皮内注射，另一侧在 2 周间隔内接受 6 次氨甲环酸微针治疗。在基线和治疗后使用改良黄褐斑面积严重程度指数（mMASI）评分评估临床疗效。由 2 名皮肤科医生对全脸照片进行盲法评估。记录患者自评和满意度。
治疗后，与基线相比，两侧治疗部位的 mMASI 评分均显著降低（p <.001）。两侧治疗部位之间无显著差异（p >.05）。微针治疗侧的患者满意度高于皮内注射侧（p <.001）。两侧治疗部位均未观察到明显不良反应。
氨甲环酸皮内注射和微针治疗可安全有效地治疗黄褐斑。微针联合氨甲环酸治疗对患者更有满意度。
