Abstract

This study contrasts the safety and effectiveness of two melasma therapy methods: trichloroacetic acid (TCA) peeling and microneedling in combination with tranexamic acid (TA) and vitamin C. Over the course of six months, 30 female patients with moderate to severe epidermal melasma, ages 18 to 50, participated in a prospective, randomized, open-label trial. Patients were split into two groups: Group II had microneedling with TA and vitamin C, and Group I had 15% TCA peels. The Modified Melasma Area and Severity Index (MASI) score change, as measured at baseline, during therapy, and at follow-up, was the main end measure. The microneedling group exhibited a greater improvement (mean MASI score reduction from 9.11 to 5.21) than the TCA group (mean MASI score reduction from 22.97 to 13.16), according to the results, which indicated a substantial decrease in MASI scores in both groups. Furthermore, compared to 13.33% in the TCA group, 40% of patients in the microneedling group experienced an improvement of greater than 50%. Erythema, burning, and itching were among the mild and temporary side effects; no severe adverse events were noted. In comparison to TCA peeling, the study finds that microneedling with tranexamic acid and vitamin C is safer and more successful for treating melasma. It provides better management of hyperpigmentation with fewer adverse effects. For medical professionals looking for safe and efficient melasma treatment options, this strategy offers a viable substitute.