ABSTRACT
BACKGROUND: Tranexamic acid (TXA) in oral, topical, and intra-dermal injection routes showed efficacy in melasma treatment. Micro-needling and fractional carbon dioxide (CO2 ) laser were reported to enhance the drug delivery of TXA. AIMS: This study aimed at comparing the use of micro-needling and fractional CO2 laser for drug delivery of TXA in the treatment of facial melasma. PATIENTS/METHODS: Thirty female patients with bilateral symmetrical facial melasma were subjected to micro-needling, for one side of the face, and fractional CO2 laser, for the other, followed by an immediate topical application of TXA solution 4 mg/mL. Patients received six biweekly sessions. RESULTS: Two weeks after the last session, a significant reduction in baseline modified melasma area and severity index (mMASI) score was observed on both sides. The mean ± SD baseline mMASI dropped from 3.43 ± 1.84 to 1.59 ± 1.51 (mean reduction 57.73%, P < .001) and from 3.51 ± 1.84 to 1.78 ± 1.51 (mean reduction 55.82%, P < .001) in the micro-needling-treated side and in the fractional CO2 laser-treated side, respectively. However, no statistically significant differences were found between the two sides (P = .81). CONCLUSIONS: Micro-needling and fractional CO2 laser are equally safe and effective for the delivery of TXA in the treatment of facial melasma.
