The Effect of Platelet Rich Plasma Plus Microneedling Versus Tranexamic Acid Plus Microneedling in the Biometric Characteristics of Melasma: A Randomized, Controlled, Assessor-Blind Clinical Trial

Abstract

Background: Melasma is a persistent, acquired pigmentation disorder characterized by symmetrical hyperpigmentation or hypermelanosis in sun-exposed areas of the face. Tranexamic acid (TXA) has emerged as a prominent therapeutic option for melasma. Notably, the regression of melasma following platelet-rich plasma (PRP) treatment represents an intriguing discovery. Objectives: The primary aim of this study is to assess the efficacy of PRP combined with microneedling compared to tranexamic acid combined with microneedling in improving the severity of melasma. Methods: This study employed a split-face comparative design involving twenty patients diagnosed with melasma. Subjects underwent four sessions of PRP with microneedling on one side of the face and tranexamic acid (5) with microneedling on the opposite side. These sessions are conducted at four monthly intervals. The evaluations were conducted before the treatment and one month following the final session. Results: A total of 20 female melasma patients, with a mean age of 41 years (range: 34-49 years), were enrolled. The median ΔE, reflecting color changes, exhibited a substantial decrease in follow-up (mean difference = 6.66, P < 0.001 in TXA + microneedling group; mean difference = 1.90, P < 0.001 in PRP + microneedling group). TXA + microneedling resulted in a notable reduction in melanin measured by the Mexameter. Patient satisfaction was consisted with the other research findings. Additionally, minor transient side effects were observed, and both procedures were well-tolerated by the participants. observed, and both procedures were well-tolerated by the participants. Conclusion: This study demonstrates that PRP and tranexamic acid, when combined with microneedling, significantly contribute to melasma improvement, representing effective treatment modalities. While neither method demonstrated superiority, their comparable efficacy, safety, tolerability, and patient satisfaction suggest that they can be employed as a synergistic combination or as viable alternatives for melasma treatment. © 2024 THE AUTHORS.