Oral tranexamic acid in treatment of melasma in Pakistani population: a pilot study

Safoora Aamir, Riffat Naseem


Objective To evaluate the efficacy and safety of oral tranexamic acid (TA) in the treatment of melasma in our population.


Methods We performed a descriptive cross sectional study of 65 melasma patients (Fitzpatrick skin types III and IV). Both female and male with moderate to severe melasma were given 250mg oral TA bid for 6 months along with topical sunscreen. Digital photography was performed initially, and at each visit. Follow-up extended for another six months after completion of treatment to see any recurrence or other side effects. Results were assessed clinically and photographically.


Results 65 patients with moderate to severe melasma were enrolled in the study. The average age was 36 years. 41 patients had good, 15 had excellent and 8 patients had fair improvement. None of the patients had serious systemic side effects, only few had oligomenorrhoea, palpitation and gastric upset. Patients’ satisfaction was similarly noted.


Conclusions Oral tranexamic acid is a safe and effective treatment in patients with melasma.



Oral tranexamic acid, melasma

Full Text:



Grimes PE. Melasma. Etiologic and therapeutic considerations. Arch Dermatol. 1995;131:1453-7.

Grimes PE. Management of hyperpigmentation in darker racial ethnic groups. Semin Cutan Med Surg. 2009;28:77-85.

Gupta AK, Gover MD, Nouri K, Taylor S. Treatment of melasma: A review of clinical trials. J Am Acad Dermatol. 2006;55:1048-65.

Sanchez NP, Pathak MA, Sato S et al. Melasma: A clinical, light microscopic, ultra structural, and immunofluorescence study. J Am Acad Dermatol. 1981;4:698‑710.

Maeda K, Tomitab Y. Mechanism of the inhibitory effect of tranexamic acid on melanogenesis in cultured human melanocytes in the presence of keratinocyte-conditioned medium. J Health Sci. 2007;53:389-96.

Maeda K, Naganuma M. Topical trans-4-aminomethylcyclohexanecarboxylic acid prevents ultraviolet radiation-induced pigmentation. J Photochem Photobiol. 1998;47:136-41.

Pawaskar MD, Parikh P, Markowski T et al. Melasma and its impact on health-related Quality of life in Hispanic women. J Dermatolog Treat. 2007;18:5-9.

Bukvić Mokos Z, Lipozenčić J, Ceović R et al. Laser therapy of pigmented lesions: pro and contra. Acta Dermatovenerol Croat. 2010;18:185-9.

Kligman AM, Willis I. A new formula for depigmenting human skin. Arch Dermatol. 1975;111:40-8.

Taylor SC, Torok H, Jones T et al. Efficacy and safety of a new triple-combination agent for the treatment of facial melasma. Cutis. 2003;72:67-72.

Rendon M, Berneburg M, Arellano I, Picardo M. Treatment of melasma. J Am Acad Dermatol. 2006;54(Suppl):S272-81.

Ennes SBP, Paschoalick RC. Mota de Avelar Alchorne M. A double-blind, comparative, placebo-controlled study of the efficacy and tolerability of 4% hydroquinone as a depigmenting agent in melasma. J Dermatolog Treat. 2000;11:173-9.

Ejaz A, Raza N, Iftikhar N, Muzzafar F. Comparison of 30 % salicylic acid with Jessner's solution for superficial chemical peeling in epidermal melasma. J Coll Physician Surg Pak. 2008;18:205-8.

Lee JH, Park JG, Lim SH, Kim JY. Localized Intradermal microinjection of tranexamic acid for treatment of melasma in Asian patients: A preliminary clinical trial. Dermatol Surg. 2006;32:626-31.

Karn D, K C S, Amatya A et al. Q-Switched neodymium-doped:yttrium aluminium garnet laser therapy for pigmented skin lesions: efficacy and safety. Kathmando Univ Med J. 2012;38:46-50.

Nijor T. Treatment of melasma with tranexamic acid. Clin Res. 1979;13:3129-31.

Dunn CJ, Goa KL. Tranexamic acid: a review of its use in surgery and other indications. Drugs. 1999;57:1005-32.

Karn D, K C S, Amatya A et al. Oral tranexamic acid for the treatment of melasma. Kathmandu Univ Med J. 2012;10:40-3.

Wu S, Shi H, Wu H et al. Treatment of melasma with oral administration of tranexamic acid. Aesthetic Plast Surg. 2012;36:964-70.

Ayuthaya PKN, Niumphradit N, Manosroi A, Nakakes A. Topical 5% tranexamic acid for the treatment of melasma in Asians: A double-blind randomized controlled clinical trial. J Cosmet Laser Ther. 2012;14:150-4.

Na JI, Choi SY, Yang SH et al. Effect of tranexamic acid on melasma: a clinical trial with histologic evaluation. J Eur Acad Dermatol Venereol. 2012;


  • There are currently no refbacks.

ISSN: 1560-9014