1* Junior Resident, Department of Dermatology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam-603103, Tamil Nadu, India. (Corresponding Author) Email: gokulbabu99@gmail.com. ORCID ID: 0009-0006-4281-3570
2 Professor, HOD, Department of Dermatology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam-603103, Tamil Nadu, India. Email: dermdrgopalakrishnan@gmail.com. ORCID ID: 0009-0009-2837-3320
Corresponding Author: Dr. Gokul Babu Ambady, Junior Resident, Department of Dermatology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam-603103, Tamil Nadu, India. Email: gokulbabu99@gmail.com. ORCID ID: 0009-0006-4281-3570
Received: 20th Feb, 2026 | Revised: 4th Mar, 2026 | Accepted: 25th Mar, 2026 | Available Online: 10th Apr, 2026
Background: Topical hydroquinone (HQ) is the gold standard in melasma management; even when it causes many side effects. An antifibrinolytic tranexamic acid (TXA) emerged as an alternative in management of melasma, hence the current study was proposed to compare the effectiveness and safety of TXA over HQ.
Material and methods: Comparative study was done in patients with melasma attending dermatology department (sample size 100) after getting institute's ethical approval (IHEC-I/3987/25). Patients who met the inclusion criteria were grouped as Group A (50): Topical tranexamic acid was used, Group B: hydroquinone was used. Modified Melasma Area and Severity Index (MASI) scores at baseline, 4 week, 8 week, 12 weeks and patients satisfaction score at the end of study period were noted. Analysis done using SPSS version 22.
Results: Group A and B have statistically significant decrease in MASI scores by the end of study period. Paired analysis showed a significant within group effect in both the groups (group A = d/3.9, group B = d/3.69). Group A patients satisfaction score was significantly higher compared to group B (56% and 40% reported excellent improvement, P = 0.04).
Conclusion: Patients in both groups reported significant improvement in MASI scores, while group A (TXA) showed lower incidence of side effects and excellent patient satisfaction compared to group B.
Keywords: Comparative study, effectiveness, side effect profile, melasma, topical tranexamic acid (4%), hydroquinone (2%).
How to cite this article: Ambady GB, Gopalakrishnan K. Comparative Evaluation of the Efficacy of Topical Tranexamic Acid (4%) Versus Hydroquinone (2%) in the Treatment of Melasma of the Adult Age Group (35-55 Yrs) in Tertiary Health Care Chennai. Int J Drug Deliv Technol. 2026;16(4):521-527. DOI: 10.25258/ijddt.16.4.53
Source of support: Nil.
Conflict of interest: The authors declare no conflict of interest.