Resumen

Objectives: To assess the short-term efficacy and safety of intradermal tranexamic acid, glutathione, and hyaluronic acid combination therapy in patients with melasma Introduction: Melasma is a chronic, relapsing pigmentary disorder with significant psychosocial impact and variable response to standard therapies. Intradermal delivery of depigmenting and antioxidant agents such as tranexamic acid, glutathione, and hyaluronic acid has emerged as a promising adjuvant approach. However, evidence supporting their combined use remains limited, especially in Indian skin types. Materials / method: Ten female patients with melasma received intradermal injections of tranexamic acid, glutathione, and hyaluronic acid at two-week intervals for three sessions over six weeks. All patients were advised strict photoprotection. Clinical evaluation was performed using the modified Melasma Area and Severity Index (mMASI) at baseline and weeks 2, 4, and 6. Safety and tolerability were also assessed. Results: The mean age was 44 years, with Fitzpatrick skin types III (55%) and IV (45%). Mean disease duration was 4.7 years, and 40% had a family history. A progressive and statistically significant reduction in mMASI scores was observed at weeks 4 and 6. The treatment was well tolerated, with no significant adverse effects reported. Conclusion: Intradermal tranexamic acid, glutathione, and hyaluronic acid combination appears to be a safe and effective adjuvant therapy for melasma, showing significant improvement within six weeks. Larger controlled studies are required to validate these findings