A comparative study between micro needling with modified Kligman regimen versus micro needling with tranexamic acid in melasma patients

Anjum M. Momin, Ankita A. Mistry, Jignesh B. Vaishnani


Background: Melasma is common, acquired disorder of hyperpigmentation, with female predominance and occurrence of facial involvement mostly. Various modalities of treatment are available including topical, oral and procedural therapies.

Methods: Total 46 patients of melasma were studied. They were divided in two groups A and B. Micro needling with derma roller 1.5mm was done once in a month for 3 months. Group A patients received topical Modified Kligman regimen daily at night, while group B patients were advised topical tranexamic acid daily. Topical sunscreen was advised in both group patients. Patients were evaluated clinically and by Modified MASI score, and followed up for 3 more months after completion of treatment.

Results: Female predominance was noted with most common age group being 25-40 years. Epidermal type of melasma was common. Centro-facial type of distribution was found mostly in patients. Significant decrease was noted in modified MASI score (p<0.05) which was more and rapid in group A patients.

Conclusions: Modified Kligman regimen has better efficacy but tranexamic acid is safer with lesser side effects. Inspite of various treatment arms, melasma is still challenging.


Melasma, Micro needling, Modified Kligman regimen, Tranexamic acid

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