Recently, topical Tranexamic acid (TXA) has been used in melasma management. On detail search of literature, this may be the first study assessing efficacy on combining of Topical TXA with GA peel in melasma. To assess efficacy, safety and improvement in quality of life index on combining 30% GA peel with 5% TXA solution topically in melasma of epidermal type. 60 patients of epidermal melasma were categorised into two groups: Combination group were treated with 30% GA peel at 2 weekly intervals with 5% TXA solution applied twice daily and Control group were treated with only 30% GA peel every 2 weeks for 12 weeks.
Melasma area severity index (MASI) was used for assessing clinical improvement. Hi-MELASQOL and HRQOL scales were used to measure Melasma related quality of life and were compared between both groups. At each visit adverse effects were noted. A significantly decreasing trend was seen regarding the MASI score when compared within the group, but the difference was statistically not significant between the two groups at 12 weeks.
Similarly, there was significant improvement in Hi-MELASQOL and HRQOL in both the groups, but the difference between them was statistically not significant. Side effects experienced by patients in both groups were trivial and did not requiring stoppage of therapy. Topical TXA with GA peel has comparable result with GA peel alone, but the therapeutic response was achieved in patients of combination group earlier in comparison to control group patients.