New local treatments for different types of melasma: Vascular type vs nonvascular type. A randomized polycentric study.

Melasma is an acquired circumscribed hyperpigmented disorder seen mainly on the malar area of face and other parts of body. We evaluated the safety and efficacy of two different creams for melasma. Sixty volunteers with melasma were evaluated in this study, divided in three groups: A, B, and C. Patients in groups A and B were treated with same creams with the exception of addition of Tranexamic acid in cream B. Patients in group C were treated with placebo cream containing petrolatum only, respectively, twice daily for 10 weeks. Melasma Areas and Severity Index (MASI) score, melanin index (MI) and adverse events were evaluated every 4 weeks. MASI scores declined significantly in groups A and B compared to group C (P < .05). Cream B, containing tranexamic acid, resulted superior to cream A in subjects with hypervascular melasma. No adverse reactions were observed in all groups. Both active creams are safe and effective for melasma and should be selected according to normal or hypervascular type of melasma. Cream B (containing tranexamic acid) should be prescribed instead of cream A (not containing tranexamic acid) to subjects with hypervascular melasma.