Melasma is a chronic acquired disorder of facial hyperpigmentation that significantly affects quality of life. Both intralesional tranexamic acid and mandelic acid chemical peels are effective treatment options with favorable safety profiles in darker skin types. However, comparative evidence in South Asian populations is limited. This study aims to compare the efficacy, safety, quality of life outcomes, and patient satisfaction of intralesional tranexamic acid versus mandelic acid peel in patients with facial melasma treated at Combined Military Hospital Abbottabad.
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Parallel
Mandelic Acid Peel
Procedure/SurgeryAfter degreasing the face, mandelic acid solution will be applied for 5-7 minutes and then neutralized. Sessions will be repeated every two weeks for six sessions.
Intralesional Tranexamic Acid
Procedure/SurgeryTranexamic acid will be injected intradermally at 1-cm intervals over melasma patches using a 30-gauge insulin syringe every two weeks for six sessions.
Proportion of participants achieving a Physician Global Assessment rating of good or excellent.
Good response is defined as ≥51% improvement and excellent response as ≥76% improvement in pigmentation.
Change in modified Melasma Area and Severity Index(0-24), 0-clear, 24-severe
Change in Melasma Quality of Life Scale MELASQoL score(7-70) 10 - 39: Mild quality of life impairment, 40 - 54: Moderate quality of life impairment, 55 - 70: Severe quality of life impairment .
Patient satisfaction score (Likert Scale 1-5, 1:Very Dissatisfied, 5: Satisfied)
Frequency of treatment-related adverse events
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