Comparison of effectiveness of oral tranexamic acid with that of the topical modified Kligman's formula in the treatment of melasma

Context: Melasma is an acquired disorder of hyperpigmentation presenting over the face. Modified Kligman's formula is used most commonly as treatment modality. Considering the various side effects of individual components of topical modified Kligman's formula, the use of oral tranexamic acid might be a better and safer alternative for the treatment of melasma. Aims: This study aims to compare the efficacy of oral tranexamic acid with that of topical modified Kligman's formula in the treatment of melasma. To assess the degree of improvement in pigmentation objectively using Melasma Area and Severity Index at baseline and after 4 weeks of treatment with oral tranexamic acid and topical modified Kligman's formula and to compare the side effects, if any, associated with both the modalities. Settings and Design: This was randomized, comparative, prospective, open-labeled study. Methods: This study was done in a tertiary care hospital from September 2018 to June 2019. Overall, 40 patients with clinical diagnosis of melasma were included in the study. Statistical Analysis Used: Paired t-test and unpaired t-test. Results: Improvement was noted in patients belonging to both the groups. After applying paired t-test, it was found that results were statistically significant in both the treatment groups. When both the groups were compared statistically using unpaired t-test, both the groups showed statistically equivalent results. Conclusions: Both oral tranexamic acid and modified Kligman's formula were equally effective in the treatment of melasma. Oral tranexamic acid is a better and safer alternative than the modified Kligman's formula to initiate the treatment in melasma.