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

Background: Melasma is a challenging hypermelanotic disorder, which is difficult to treat. Different modalities of laser therapy have been tried for the treatment of melasma such as fractional CO2 laser. Tranexamic acid (TXA) has been suggested as an effective treatment for melasma, with promising results. Objective: The aim of this study isto assess and comparethe efficacy of tranexamic acid intradermal microinjection alone versus its combination with low power low-density fractional CO2 laser in a sequential pattern. Methods: A total of twenty-nine patients with bilateral, symmetrical melasma were enrolled in this randomized comparative split face study. One side of the face was randomly assigned to low power low-density fractional CO2 laser, while other side to TXA intradermal microinjection on 1st session. This split face session was repeated every six weeks for 3 sessions. In addition, TXA was applied by microinjection for full face every two weeks in between the split face sessions in sequential pattern.The treatment duration was 4 months. Efficacy was evaluated using digital photography, dermoscopy, melanin index (M.I) and erythema index (E.I) at baseline and four weeks after the last session. Patient satisfaction score was also assessed

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