Triamcinolone injection at low concentration significantly reduces melasma severity, researchers reported in a study published in the Journal of Cosmetic Dermatology.
The study assessed the efficacy and safety of intralesional triamcinolone compared with Kligman formula in 2 groups of women with melasma. Group 1 (22 patients; mean age, 37.05 ± 6.41) was treated with intralesional triamcinolone dermal injection by insulin syringe at a concentration of 4 mg/mL, 1 cm apart between injected points, with a maximum dose of 20 mg per session. The treatments were repeated monthly until complete clearance of melasma or for a maximum of 4 sessions. Group 2 (22 patients; mean age, 37.86 ± 7.04) was treated with Kligman formula (hydroquinone 5%, tretinoin 0.1%, and dexamethasone 0.1%) once nightly for a maximum of 3 months. All patients were evaluated with a dermoscope before treatment and at each follow-up visit.
Based on scores on the Melasma Area and Severity Index (MASI), melasma severity significantly decreased in both groups at the end of the third month, and no statistically significant difference in therapeutic response was observed in the 2 groups. After 3 months, the mean percent of decrease in MASI was 54.46 ± 21.62 in the triamcinolone group vs 57.86 ± 19.75 in the group that received Kligman formula. Mild pain during injection was reported in the triamcinolone group, and Kligman formula was associated with dermatitis, irritation, and burning sensation.
After 3 months of treatment, the therapeutic response was good in 11 patients (50%) in both groups, medium in 7 patients (31.8%) in the triamcinolone group vs 8 patients (36.4%) in the Kligman group, and poor in 4 patients (18.2%) in the triamcinolone group vs 3 patients (13.6%) in the Kligman group.
“This study showed significant reduction in the severity of melasma after 4 treatment sessions with intralesional triamcinolone injection, with no statistically significant difference in the therapeutic response between triamcinolone injection and Kligman formula,” stated the investigators.
“Intralesional triamcinolone in low concentration could be an alternative simple, economic and safe treatment modality for melasma,” the study authors commented. “However, further studies are still needed to confirm these results and to reach the most effective and safe concentration of triamcinolone injection therapy for melasma.”
Elrahman Nassar AA, Ibrahim AM, Mahmoud AA. Efficacy and safety of intralesional steroid injection in the treatment of melasma [published online August 2, 2020]. J Cosmet Dermatol. doi: 10.1111/jocd.13628