Oral tranexamic acid lightens refractory melasma

Abstract

Low-dose oral tranexamic acid can serve as a safe and useful adjunct in the treatment of refractory melasma.

Efficacy and Safety of Tranexamic Acid in Melasma: A Meta-analysis and Systematic Review

“…After excluding studies that did not meet criteria for inclusion in the analysis, 11 studies were deemed appropriate and were included for meta-analysis ( Fig. 1) (7,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Among the included studies we had 1 abstract and 1 poster material (15,17).…”

“…All study patients were adults; 80-100% women. Of the 11 trials, 4 were from Korea (7,15,22,23), 3 from India (17, 18, 21) and 1 from each of the following countries: Brazil (16), Iran (19), Nepal (20) and Singapore (14). Melasma severity was assessed by MASI (8 studies were assessed with the original MASI scoring (24) and 3 with 2 different forms of modified MASI scoring (18,25)).…”

“…differed among these studies. Oral TA (500-1,500 mg/day) was applied alone in 2 studies (14,15) and as an adjuvant in 3 studies (20,21,23) for 2-6 months. Topical TA in 2-3% concentrations was applied alone in 2 studies (16,19) and as an adjuvant in one study (22) for 3-7 months.…”

“…Of the 11 studies included, 3 were RCTs (16, 20, 21), 7 were before-after comparison (7,(14)(15)(16)(17)(18)(19) and one was a retrospective cohort study (23). The quality of the studies evaluating TA treatment in melasma varied, but was generally poor (Fig.…”

“…MASI reduction (change in MASI between pre-treatment and post-treatment) was the primary outcome measure of 7 melasma studies with TA application alone (7,(14)(15)(16)(17)(18)(19). (Fig.…”