Efficacy and Safety of Mesotherapy with Tranexamic Acid Versus Vitamin C in the Treatment of Melasma: A Comparative Clinical Review

Abstract

Background: Melasma is a common hyperpigmented skin disorder primarily affecting young and middle-aged women. Treatments have increasingly focused on reducing melanin production, with tranexamic acid (TXA) and vitamin C emerging as potential options. Methods: Following the PRISMA guidelines, a comprehensive search was conducted across PubMed, ScienceDirect, and SagePub databases, focusing on clinical studies published between 2014 and 2024. Results: The analysis included five clinical studies comprising 137 patients. Both TXA and vitamin C treatments resulted in significant improvement in MASI scores over the treatment period. Both treatments demonstrated similar outcomes in terms of PGA and patient satisfaction. Additionally, both were well tolerated, with no reports of severe adverse effects. Conclusion: Tranexamic acid and vitamin C are effective and safe treatments for melasma, with comparable efficacy in reducing hyperpigmentation. While both options are viable, further research is needed to explore their long-term benefits and optimize treatment protocols for different patient populations.