Therefore, the hospital-based randomized controlled study involved 70 participants aged 18 to 60 years and was conducted over four treatment sessions at four-week intervals between November 2022 and April 2024 to compare 4 mg/mL of tranexamic acid delivered via a 1.5 mm derma-roller versus intradermal injections with an insulin syringe. Enhanced Clearance Rates: Approximately 82.9% of patients in the microneedling group reported nearly cleared melasma on the PGA scale, whereas only 37.1% reached this significant milestone in the intradermal group. Greater Clinical Response: Photographic evidence showed that over 71% of microneedling participants experienced more than 50% clinical improvement, which was significantly higher than the 40% observed in the injection cohort. Thus, the study concludes that clinicians might consider microneedling with tranexamic acid as a more efficient and satisfying treatment strategy for patients managing various patterns of melasma. ReferenceSrijha M, Kaliyaperumal D, Dileep JE, Kuruvila S. Efficacy of tranexamic acid microneedling versus intradermal injection of tranexamic acid in the treatment of melasma – A randomised controlled trial.