Efficacy of oral tranexamic acid in patients with melasma
Abstract
Introduction: Tranexamic acid has emerged as a promising treatment for melasma; however, few controlled studies exist. Oral tranexamic acid has been reported to be effective for treating melasma however, the effect of topical tranxemic acid remains controversial. The purposed mechanism is that it inhibits plasminogen keratinocyte interaction which decreases tyrosinase activity leading to decreased melanin synthesis by melanocytes. Objectives: To determine the efficacy of oral tranexamic acid for management of patients presenting with melasma. Materials & Methods: A total of 80 patients of moderate to severe melasma, 15 to 50 years of age were included. Patients were given 250 mg tranexamic acid twice daily alongwith sunscreen creams for the duration of 3 months. The patients were followed up every month.Efficacy was assessed by decrease in mMASI score from the baseline. Results: Eighty patients with age range from 15 to 50 years were included in the study. Mean age was 31.94 ± 6.29 years. There were 23 (28.75%) males and 57 (71.25%) females with male to female ratio 1:2.5. Mean duration of disease was 10.19 ± 2.09 months. Mean baseline mMASI score was 23.04 ± 5.14. Efficacy of oral tranexamic acid in patients with melasma was found in 32 (40.0%) patients. Conclusion: Oral tranexamic acid is effective safe and well tolerated treatment option for patients with moderate to severe melasma. Keywords: Melasma, oral tranexamic acid, efficacyReferences
Kim HJ, Moon SH, Cho SH, Lee JD, Sung Kim H. Efficacy and safety of tranexamic acid in melasma: a meta-analysis and systematic review. Acta Derm Venereol. 2017;97(6–7):776–81.
Bala HR, Lee S, Wong C, Pandya AG, Rodrigues M. Oral tranexamic acid for the treatment of melasma: a review. Dermatologic Surg. 2018;44(6):814–25.
Karn D, Kc S, Amatya A, Razouria EA, Timalsina M. Oral tranexamic acid for the treatment of melasma. Kathmandu Univ Med J. 2012;10(4):40–3.
Handel AC, Miot LDB, Miot HA. Melasma: a clinical and epidemiological review. An Bras Dermatol. 2014;89:771–82.
Kakru SN, Raihan M, Beg MA, Kakroo B. Efficacy of Oral Tranexamic Acid in the Treatment of Melasma: Int Arch BioMed Clin Res. 2017;3(4):93-6.
Del Rosario E, Florez-Pollack S, Zapata Jr L, Hernandez K, Tovar-Garza A, Rodrigues M, et al. Randomized, placebo-controlled, double-blind study of oral tranexamic acid in the treatment of moderate-to-severe melasma. J Am Acad Dermatol. 2018;78(2):363–9.
Sharma R, Mahajan VK, Mehta KS, Chauhan PS, Rawat R, Shiny TN. Therapeutic efficacy and safety of oral tranexamic acid and that of tranexamic acid local infiltration with microinjections in patients with melasma: a comparative study. Clin Exp Dermatol. 2017;42(7):728–34.
Yalamanchili R, Shastry V, Betkerur J. Clinico-epidemiological study and quality of life assessment in melasma. Indian J Dermatol. 2015;60(5):519.
Taraz M, Niknam S, Ehsani AH. Tranexamic acid in treatment of melasma: A comprehensive review of clinical studies. Dermatol Ther. 2017;30(3):e12465.
Colferai MMT, Miquelin GM, Steiner D. Evaluation of oral tranexamic acid in the treatment of melasma. J Cosmet Dermatol. 2019;18(5):1495–501.
Amer Ejaz NR, Iftikhar N, Muzzafar F. Comparison of 30% salicylic acid with Jessner’s solution for superficial chemical peeling in epidermal melasma. J Coll Physicians Surg Pakistan. 2008;18(4):205–8.
Bari AU, Iqbal Z, Rahman SB. Tolerance and safety of superficial chemical peeling with salicylic acid in various facial dermatoses. Indian J Dermatol Venereol Leprol. 2005;71(2):87–90.
Ethawi AMD, Sidiq LM. Comparison of the effect of salicylic acid chemical peel combined with topical modified kligman formula and topical modified kligman formula alone in the treatment of melasma. Iraqi Postgr Med J. 2011;10(2):191–7.
Lee HS, Won CH, Lee DH, An JS, Chang HW, Lee JH, et al. Treatment of melasma in Asian skin using a fractional 1,550â€nm laser: an open clinical study. Dermatologic Surg. 2009;35(10):1499–504.
I Al-Hamdi K, J Hasony H, L Jareh H. Melasma in Basrah: A clinical and epidemiological study. Med J Basrah Univ. 2008;26(1):1–5.
Tan AWM, Sen P, Chua SH, Goh BK. Oral tranexamic acid lightens refractory melasma. Australas J Dermatol. 2017;58(3):e105–8.
Wu S, Shi H, Wu H, Yan S, Guo J, Sun Y, et al. Treatment of melasma with oral administration of tranexamic acid. Aesthetic Plast Surg. 2012;36(4):964–70.
Li Y, Sun Q, He Z, Fu L, He C, Yan Y. Treatment of melasma with oral administration of compound tranexamic acid: a preliminary clinical trial. J Eur Acad Dermatoly Venereol. 2014;3(28):393–4.
Zhu C-Y, Li Y, Sun Q-N, Takada A, Kawada A. Analysis of the effect of different doses of oral tranexamic acid on melasma: a multicentre prospective study. Eur J Dermatology. 2019;29(1):55–8.
Khurana VK, Misri RR, Agarwal S, Thole A V, Kumar S, Anand T. A randomized, open-label, comparative study of oral tranexamic acid and tranexamic acid microinjections in patients with melasma. Indian J Dermatol Venereol Leprol. 2019;85(1):39–43.
