Intradermal Tranexamic Acid Vs Intradermal Platelet-Rich Plasma In The Treatment Of Melasma- A Randomised Control Study

Melasma is a common, multifactorial hyperpigmentation disorder that negatively impacts quality of life. While many topical and procedural treatments exist for this condition, a definitive therapy remains elusive. The study focuses on two modern intradermal therapies Tranexamic Acid (TXA), which inhibits UV induced plasmin activity in keratinocytes, and Platelet Rich Plasma (PRP), which uses growth factors like TGF beta1 to inhibit melanin synthesis. The existing literature provides conflicting results from previous studies comparing these two modalities, thereby establishing the need for further research. The primary aim of the study is to compare the efficacy of intradermal TXA versus intradermal PRP in the treatment of melasma. The objectives are to evaluate the effectiveness of each treatment individually and then to compare the outcomes of the two treatment arms. This will be a randomized prospective interventional study. We will enroll 40 patients who will be randomized into two groups of 20 each. Group A will receive intradermal injections of TXA. Group B will receive intradermal injections of autologous PRP. The treatment will consist of a maximum of four sessions administered at four weekly intervals for both groups. Patients aged 18 to 50 years are eligible for inclusion , while those who are pregnant, breastfeeding, on oral contraceptives, or have bleeding disorders are among those who will be excluded. The primary outcome will be the evaluation of efficacy via the modified Melasma Area and Severity Index (mMASI) score. Written informed consent will be obtained from all participants.