Comparison of the Efficacy of Intradermal Tranexamic Acid and Topical Triple Combination Modification in Decreasing the Severity Score of Melasma: A Meta-analysis
Melasma is a symmetrical chronic hypermelanosis that affects the skin of the face, characterised by brownish patches with uneven margins, particularly in areas regularly exposed to sunlight. Although topical triple combination modifications are good first-line therapy for melasma, they have a wide r...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-03-01
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| Series: | Indian Journal of Dermatology |
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| Online Access: | https://journals.lww.com/10.4103/ijd.ijd_1002_23 |
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| author | Anindia Indraswari Diah Mira Indramaya Maylita Sari Budi Utomo Evy Ervianti Trisniartami Setyaningrum Astindari Astindari Menul Ayu Umborowati |
| author_facet | Anindia Indraswari Diah Mira Indramaya Maylita Sari Budi Utomo Evy Ervianti Trisniartami Setyaningrum Astindari Astindari Menul Ayu Umborowati |
| author_sort | Anindia Indraswari |
| collection | DOAJ |
| description | Melasma is a symmetrical chronic hypermelanosis that affects the skin of the face, characterised by brownish patches with uneven margins, particularly in areas regularly exposed to sunlight. Although topical triple combination modifications are good first-line therapy for melasma, they have a wide range of negative effects. Consequently, new effective treatments with fewer side effects are required. It has been observed that intradermal tranexamic acid (TA) has low adverse effects and a good therapeutic response in treating melasma. This study aimed to assess the degree of the melasma area and severity index in patients treated with topical triple combination modifications and intradermal tranexamic acid therapy. Electronic databases were searched for relevant articles based on predetermined eligibility requirements. The statistical analysis was conducted using the Review Manager (RevMan) v5.4 software. Randomized controlled trials were used in designing three investigations with a total of 184 patients. After intervention, there was a significant difference in the MASI score between the intradermal tranexamic acid group and the modified topical triple combination group, with a mean difference (MD) of -0.81 (95% CI [-1.05, -0.57]), a combined result of 6.54 with P < 0.00001 and low heterogeneity (I2 = 0%). The intradermal tranexamic acid group also demonstrated a lower MASI score, and the funnel plot revealed no publication bias. This study found that intradermal tranexamic acid is more effective than topical triple combination modifications and has fewer side effects. Therefore, it can serve as an alternative primary therapy option for melasma. |
| format | Article |
| id | doaj-art-b2dd3e7beea84dd5bb5529eee3ccd4e4 |
| institution | OA Journals |
| issn | 0019-5154 1998-3611 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Dermatology |
| spelling | doaj-art-b2dd3e7beea84dd5bb5529eee3ccd4e42025-08-20T02:04:48ZengWolters Kluwer Medknow PublicationsIndian Journal of Dermatology0019-51541998-36112025-03-01702899610.4103/ijd.ijd_1002_23Comparison of the Efficacy of Intradermal Tranexamic Acid and Topical Triple Combination Modification in Decreasing the Severity Score of Melasma: A Meta-analysisAnindia IndraswariDiah Mira IndramayaMaylita SariBudi UtomoEvy ErviantiTrisniartami SetyaningrumAstindari AstindariMenul Ayu UmborowatiMelasma is a symmetrical chronic hypermelanosis that affects the skin of the face, characterised by brownish patches with uneven margins, particularly in areas regularly exposed to sunlight. Although topical triple combination modifications are good first-line therapy for melasma, they have a wide range of negative effects. Consequently, new effective treatments with fewer side effects are required. It has been observed that intradermal tranexamic acid (TA) has low adverse effects and a good therapeutic response in treating melasma. This study aimed to assess the degree of the melasma area and severity index in patients treated with topical triple combination modifications and intradermal tranexamic acid therapy. Electronic databases were searched for relevant articles based on predetermined eligibility requirements. The statistical analysis was conducted using the Review Manager (RevMan) v5.4 software. Randomized controlled trials were used in designing three investigations with a total of 184 patients. After intervention, there was a significant difference in the MASI score between the intradermal tranexamic acid group and the modified topical triple combination group, with a mean difference (MD) of -0.81 (95% CI [-1.05, -0.57]), a combined result of 6.54 with P < 0.00001 and low heterogeneity (I2 = 0%). The intradermal tranexamic acid group also demonstrated a lower MASI score, and the funnel plot revealed no publication bias. This study found that intradermal tranexamic acid is more effective than topical triple combination modifications and has fewer side effects. Therefore, it can serve as an alternative primary therapy option for melasma.https://journals.lww.com/10.4103/ijd.ijd_1002_23intradermal tranexamic acidkligman’s formulamasimelasmamelasma severity scoretopical triple combination modifications |
| spellingShingle | Anindia Indraswari Diah Mira Indramaya Maylita Sari Budi Utomo Evy Ervianti Trisniartami Setyaningrum Astindari Astindari Menul Ayu Umborowati Comparison of the Efficacy of Intradermal Tranexamic Acid and Topical Triple Combination Modification in Decreasing the Severity Score of Melasma: A Meta-analysis Indian Journal of Dermatology intradermal tranexamic acid kligman’s formula masi melasma melasma severity score topical triple combination modifications |
| title | Comparison of the Efficacy of Intradermal Tranexamic Acid and Topical Triple Combination Modification in Decreasing the Severity Score of Melasma: A Meta-analysis |
| title_full | Comparison of the Efficacy of Intradermal Tranexamic Acid and Topical Triple Combination Modification in Decreasing the Severity Score of Melasma: A Meta-analysis |
| title_fullStr | Comparison of the Efficacy of Intradermal Tranexamic Acid and Topical Triple Combination Modification in Decreasing the Severity Score of Melasma: A Meta-analysis |
| title_full_unstemmed | Comparison of the Efficacy of Intradermal Tranexamic Acid and Topical Triple Combination Modification in Decreasing the Severity Score of Melasma: A Meta-analysis |
| title_short | Comparison of the Efficacy of Intradermal Tranexamic Acid and Topical Triple Combination Modification in Decreasing the Severity Score of Melasma: A Meta-analysis |
| title_sort | comparison of the efficacy of intradermal tranexamic acid and topical triple combination modification in decreasing the severity score of melasma a meta analysis |
| topic | intradermal tranexamic acid kligman’s formula masi melasma melasma severity score topical triple combination modifications |
| url | https://journals.lww.com/10.4103/ijd.ijd_1002_23 |
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