Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Dermatology and Venerology

Background: Melasma is a complex common skin disorder mainly affecting females and characterized by irregular light to dark brown or grayish macules and/or patches mostly with underlying genetic, hormonal and environmental factors having no definitive treatment. Tranexamic acid (TXA) has lately gained popularity as an adjuvant therapy in some pigmentary disorders. Vitamin C (vit.C), an essential dietary nutrient, plays a role in the maintenance of proper skin functions through its action on wound healing, photoprotection, skin hydration, anti aging, as well as depigmentation. Aim of work: The present study aims at evaluating and comparing the therapeutic effects of topical TXA and Vit.C with microneedling (MN) in the treatment of melasma. Patients and methods: In a right-left comparative study, thirty female melasma patients were evaluated and underwent Wood{u2019}s light examination, dermoscopic evaluation, MASI scoring (mMASI, MASIMR and MASIML) by investigator and two blinded evaluators, and visual analogue score (VAS) by physician, by patient and blinded evaluators, as well as DLQI, before, during and after the study period (at 0,4,12 and 16 wks). Following a preliminary preparatory period of four weeks where Kligman{u2019}s formula was applied on both sides, the right side of the face was treated with TXA (500mg/5ml) plus microneedling and the left with Vit.C 20% followed by microneedling for five successive biweekly treatments. A final evaluation was performed four weeks after last treatment

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