In patients with melasma, the combination of 5% topical tranexamic acid with 30% glycolic acid peel has comparable results when compared to 30% glycolic acid peel alone, says a study published in Dermatologic therapy. However, the therapeutic response was attained more promptly in patients of the combination group in comparison to the control group patients.

Investigators undertook this prospective, open-label, randomized study for exploring the efficacy, safety, and improvement in the quality of life index on the combination of glycolic acid peel with tranexamic acid solution topically to treat epidermal melasma. Overall, 60 individuals with epidermal melasma were incorporated and were segregated into (i) Combination group: Treatment with 30% glycolic acid peel at two weekly intervals followed by application of 5% tranexamic acid solution twice daily, and (ii) Control group: Treatment with only 30% glycolic acid peel every two weeks for 12 weeks.

For determining clinical improvement, the melasma area severity index (MASI) was utilized, and for estimating Melasma related quality of life, Hindi-Melasma quality of life (Hi-MELASQOL) and Health Related Quality of Life (HRQOL) scales were utilized. At each visit, an assessment of the adverse effects was done. When compared within the group, a considerably decreasing trend was witnessed regarding the MASI score. But, the difference was profoundly not significant between the combination and control arms at 12 weeks. But, a considerable decline in MASI score was achieved more rapidly in the combination arm when compared to the control arm.

In both groups, substantial improvements in HRQOL and Hi-MELASQOL was noted. However, the difference between them was not substantially significant. The adverse effects witnessed by participants in both combination and control groups were trivial and did not need a cessation of treatment. Thus, 30% glycolic acid peel can be safely combined with topical tranexamic acid to attain the therapeutic response earlier in melasma patients.