Comparison of Efficacy of Oral Tranexamic Acid Versus Glycolic Acid Peels in the Treatment of Melasma

Abstract

Objective: To compare the efficacy of oral tranexamic acid versus glycolic acid peels in the treatment of epidermal
and mixed-pattern melasma.
Methodology: A total of 88 patients, aged 20 to 50 years, diagnosed with epidermal or mixed-pattern melasma, were
assigned to two treatment groups based on their treatment choice or eligibility criteria. Group A received oral
tranexamic acid (250 mg twice daily), and Group B underwent 50% glycolic acid peels every two weeks for 12 weeks.
MASI scores were recorded at baseline and at 12 weeks to assess the extent of improvement, and side effects were
monitored.
Results: The baseline MASI score for all patients was 14.74 (SD = 3.09). At 12 weeks, the mean MASI score significantly
decreased to 2.45 (SD = 1.70). Both groups showed substantial improvements in MASI scores. Group A had a mean
MASI score of 15.5 at baseline, which reduced to 3.2, while Group B showed a mean reduction from 14.9 to 4.8.
Statistical analysis revealed no significant difference in efficacy between the two treatments (p-value =0.05).
Conclusion: Both oral tranexamic acid and glycolic acid peels are effective in treating melasma, with comparable
results. Future studies with larger sample sizes and longer follow-up are recommended to assess long-term outcomes and potential combination therapies.
Keywords: Glycolic acid peels; MASI score; Melasma; Oral tranexamic acid; Treatment efficacy