Comparison of MASI Score Between Intense Pulsed Light Versus Intradermal Tranexamic Acid to Treat Melasma

Abstract

Dr Arooj Fatima, Dr Saba Amin, Dr Nighat Fatima, Dr Ashifa Shams and Dr Shamayem Imdad

Background:  Melasma, which is a pretty common acquired pigmentary disturbance, tends to show up on sun-exposed facial patches, especially in women. From what’s known, it happens because melanogenesis is increased, mostly from ultraviolet radiation, and also because hormones add to the picture, plus there’s a genetic predisposition that makes some people more prone. There are established treatment plans for it, using both pharmaceutical agents and energy-based approaches. For instance, Intense Pulsed Light and intradermal tranexamic acid are now considered workable choices. However, there are only limited comparative data about how well they do versus each other for lowering the Melasma Area and Severity Index, often just called the MASI score.

Objective: To compare how much the Melasma Area and Severity Index, MASI, drops after treatment done with intense pulsed light IPL and intradermal tranexamic acid TXA.

Methods: So, this study was done as a prospective cohort study; it was at the Department of Dermatology, Ibn-e-Siena Hospital, Multan, from 6th May 2025 to 6th November 2025. In total, sixty patients with a clinical diagnosis of melasma were picked, then split into two groups of 30 each. Intense pulsed light therapy was given to Group A, and tranexamic acid was given as injections in the skin to Group B. Pre-treatment and post-therapy assessments of the MASI baseline MASI scores were taken. The data was analyzed using SPSS version 26, and the mean score decrease in MASI was checked between the two groups. The p-value was less than 0.05, so it was treated as significant in a kind of particular way.

Results: In both groups, we saw a real drop in MASI scores after treatment. The mean amount of change was notably higher for the IPL group, compared with the TXA group (9.03±3.11 vs 6.46±2.88, p=0.003), which suggests IPL might be more effective. Overall, the findings point to a clear decrease in MASI in both arms once the treatment period ended, as the numbers themselves kind of confirm. Also, the average gap in MASI reduction stayed higher with intense pulsed light (9.03±3.11) than with intradermal tranexamic acid (6.46±2.88), and this difference is statistically significant (p<0.05).

Conclusion: Intense pulsed light, together with intradermal tranexamic acid, both seemed to work pretty well in bringing MASI scores down for patients with melasma. But if you take a closer look, the intense pulsed light method seems to show this more visible drop in MASI scores, especially when it comes to pigmentation severity. When I compared it with intradermal tranexamic acid, it was still helpful but not quite as much; the other approach seemed to have the stronger kind of effect, you know, almost similar, but weaker overall.

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