Comparison of therapeutic effects of liposomal Tranexamic Acid and conventional Hydroquinone on melasma. 
Melasma is one of the most common cosmetic disorders with skin darkening.  Although several treatment modalities are available, none is satisfactorily used in management of this condition.  Tranexamic acid (TA), a plasmin inhibitor, is reported to improve melasma when injected locally or used as oral and topical forms.  The aim of this study was to compare therapeutic effects of liposomal tranexamic acid and conventional hydroquinone on melasma.  Thirty women with bilateral melasma were enrolled in a split-face trial lasting 12 weeks.  Patients blindly applied 5% topical liposomal TA and 4% hydroquinone cream, to the designated sides of the face twice daily in addition to the assigned sunscreen in the morning.  Skin pigmentation was measured using MASI (Melasma Area and Severity Index) at each visit separately for each side at the base line and every month until one month after treatment course.  Data were obtained from patients file and were analyzed statistically using SPSS software, paired samples t-test, and repeated measured ANOVA.  Twenty-three patients completed the study.  The mean MASI scores significantly reduced in both treated sides (P < P = 0.001) after 12 week.  A greater decrease was observed with 5% liposomal TA, although this difference was not statistically significant.  Irritation occurred in three patients with hydroquinone, while no serious adverse events occurred with TA.  On the basis of these results, topical liposomal TA can be used as a new, effective, safe, and promising therapeutic agent in melasma.