• Sadaf Ahmed Asim, Tayyaba Iqbal, Madiha Sajid, and Sadia Bhatti.
• Department of Dermatology, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan.
• J Coll Physicians Surg Pak. 2024 May 1; 34 (5): 522526522-526.

ObjectiveTo compare the effectiveness of intense pulsed light (IPL) and intradermal tranexamic acid (TXA) in treating melasma.Study DesignA cross-sectional analytical study. Place and Duration of the Study: Department of Dermatology, Dow International Medical College, Dow University Hospital, Karachi, Pakistan, from 15th January to 15th July 2023.MethodologyA total of 62 patients with melasma, aged 20-50 years, were divided into two groups. Group A (32 patients) received IPL (560 nm filter was used) treatment, and Group B (30 patients) received intradermal TXA. Each group underwent four treatment sessions with varying intervals. Melasma area and severity index (MASI) scores were used to compare the effects of treatment.ResultsAfter a 3-month treatment period, both groups showed reduced mMASI scores compared to baseline with a significant initial difference between Group A (8.6 ± 4.2) and Group B (5.4 ± 2.7, p <0.001). However, post-treatment, there was no significant difference in mMASI scores (Group A: 3.8 ± 2.6; Group B: 3.2 ± 2.0, p = 0.29). IPL treatment (Group A) demonstrated a significant reduction in mMASI scores (57.1 ± 19.7) compared to intradermal TXA treatment (Group B, 42.2 ± 18.8, p = 0.0034).ConclusionBoth IPL and intradermal TXA treatments effectively reduced melasma, with IPL exhibiting superior results. However, post-treatment outcomes converged, emphasising the need for personalised approaches considering the unique characteristics of South East Asian skin.Key WordsIntense pulsed light, Melasma, Intradermal tranexamic acid.

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