Comparing the Efficacy of Patelet-rich Plasma (PRP) versus Tranexamic Acid (4mg/mL) as Intradermal Treatments of Melasma

Objective: To compare the efficacy of intradermal platelet-rich-plasma vs. intradermal tranexamic acid in treatment of melasma. Study Design: Non-randomised controlled trial. Place and Duration of Study: Sheikh Zayed Hospital, Rahim Yar Khan from 1st October 2019 to 30th April 2020. Methodology: Cases of melasma from either gender with age 20-40 years, were included. Diagnosis of melasma was made clinically on the basis of hyperpigmentation at sun-exposed areas and by Wood's lamp. Severity was labelled on the basis of melasma area and severity index (MASI) score. Cases in group A were managed with 1 ml of intradermal platelet-rich plasma (PRP) and those in group B were offered intradermal tranexamic acid in a dose of 4 mg. The treatment was offered every 4th week and for a total period of 12 weeks; and final outcome was seen at 24th week. At every visit, the cases were noted for their mean MASI score. Results:In this study, there were a total of 64 cases, 32 in each group. There were 19 (59.38%) males in group A and 16 (50%) in group B (p=0.61). Mean age in group A and B was 24.63 +/- 9.87 vs. 23.94 +/- 8.93 years (p= 0.76). Mean MASI score at baseline was 29.84 +/- 5.14 vs. 29.56 +/- 4.39, p=0.21. MASI was significantly better in group A at 4 weeks where score was 29.44 +/- 5.35 vs. 28.69 +/- 4.10, p=0.01. Mean MASI was 12.81 +/- 1.78 vs. 18.38 +/- 3.50, p=00001 at 12 weeks and 8.72 +/- 3.40 vs. 14.97 +/- 4.33, p=0.02 at 24 weeks in group A and B, respectively. Conclusion: Intradermal PRP is significantly better than intradermal tranexamic acid in management of melasma.