Oral tranexamic acid with fluocinolone-based triple combination cream versus fluocinolone-based triple combination cream alone in melasma: An open labeled randomized comparative trial

Padhi, Tanmay; Pradhan, Swetalina

doi:10.4103/0019-5154.164416

Cited by 38 publications

(17 citation statements)

References 22 publications

(27 reference statements)

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“…Melasma may impose major psychological and emotional burden on patients and affect their quality of life. Common therapeutic approaches for melasma include topical hydroquinone (HQ), azelaic acid, steroids, chemical peels, and lasers, most of which could not induce remarkable and constant satisfying outcomes [2, 3, 7]. …”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Therapeutic Efficacy and Safety of Tranexamic Acid Local Infiltration in Combination with Topical 4% Hydroquinone Cream Compared to Topical 4% Hydroquinone Cream Alone in Patients with Melasma: A Split-Face Study

Tehranchinia

Saghi

Rahimi

2018

Dermatology Research and Practice

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Introduction Melasma is an acquired pigmentary disorder characterized by hyperpigmented macules and/or patches affecting sun-exposed skin. Tranexamic acid (TA) can reduce melanin content of epidermis. Thus, we conducted this study to evaluate the efficacy and safety of tranexamic acid local infiltration in combination with topical 4% hydroquinone cream compared to topical 4% hydroquinone cream alone in patients with melasma. Material and Methods This study was a prospective assessor- and analyst-blind, randomized split-face clinical trial which was performed on patients with bilateral malar epidermal melasma. A total of 55 patients were enrolled, and each side of their face was randomly allocated to either TA+HQ or HQ alone treatment. The MASI score was applied as an objective measurement to compare two treatment groups. The patient's satisfaction of melasma treatment was evaluated using a four-scale grading, as well. Results The mean of MASI score in week 16 decreased in both groups significantly (p < 0.01). The therapeutic outcomes were significantly better in TA+HQ group than HQ group (p=0.001). Patients satisfaction with treatment was significantly higher in the TA + HQ group. The difference between the two groups regarding side effect occurrence was not statistically significant. Conclusion Addition of tranexamic acid injections to conventional hydroquinone therapy can increase the efficacy of topical treatment. This trial is registered with IRCT2015110324865N1.

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Section: Introductionmentioning

confidence: 99%

“…The exact mechanism of action of tranexamic acid is still unknown, but the evidence shows that it can reduce the melanin content of epidermis, decrease the dermal vascularity, and mast cell numbers[7]. …”

Section: Introductionmentioning

confidence: 99%

Evaluation of Therapeutic Efficacy and Safety of Tranexamic Acid Local Infiltration in Combination with Topical 4% Hydroquinone Cream Compared to Topical 4% Hydroquinone Cream Alone in Patients with Melasma: A Split-Face Study

Tehranchinia

Saghi

Rahimi

2018

Dermatology Research and Practice

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“…Natalia et al 71 combination of oTA with topical therapy utilizing HQ and retinoid products is recommended as a first-line treatment. These studies 42,44,50,52,58,71 suggested that oTA enhanced the efficacy of RTA, and the combination of both resulted in a 1 + 1 ≥ 2 effect due to the effect of both TA and HQ to inhibit melanin formation by melanocytes. It is worth noting that in the ΔMASI results of last follow-up, oTA combined with routine topical agents did not show statistically significant differences from oTA alone.…”

Section: Discussionmentioning

confidence: 99%

Comparative efficacy and safety of tranexamic acid for melasma by different administration methods: A systematic review and network meta‐analysis

Liang,

Luo,

Pan

et al. 2023

J of Cosmetic Dermatology

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BackgroundTranexamic acid (TA) is a new and promising drug for the treatment of melasma.ObjectivesThis network meta‐analysis aims to compare the efficacy and safety of various ways of administration of TA on melasma.MethodsWe collected researches from PubMed, EMBASE, Cochrane Library and Web of Science. Melasma area severity index (MASI) is used to evaluate the severity of melasma. After treatment with different TA administration methods, a difference in MASI is named ΔMASI. We evaluate the curative effect by comparing the ΔMASI of different TA administration methods at a certain time point.ResultsAt the Weeks 4, 8, and 12 and the last follow‐up, the ΔMASI of oral TA combined with routine topical agents (oTA + RTA) was higher than that of intradermal TA (iTA), topical TA (tTA) as well as microneedling TA (MNsTA), with statistical significance. At the 8th week, the ΔMASI of oTA was higher than that of iTA, with statistical significance. Compared with placebo, oTA showed statistically significant differences at Week 4, while tTA, iTA, and MNsTA showed statistically significant differences starting from Week 8.ConclusionsAmong various ways of administration of TA, oTA + RTA has the best effect on melasma. In the short term, the curative effect of oTA is better than that of iTA, and the onset time of oTA is faster than that of tTA, iTA and MNsTA. In the long run, the curative effect of TA alone has nothing to do with the mode of administration.

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“…5 It has also been used for the treatment of melasma. Evidence shows that TXA contributes to the reduction in epidermal melanin content, mast cell numbers, and dermal vascularity 6 ; nevertheless, its precise mechanism of action remains unknown.…”

Section: Introductionmentioning

confidence: 99%

“…It has also been used for the treatment of melasma. Evidence shows that TXA contributes to the reduction in epidermal melanin content, mast cell numbers, and dermal vascularity 6 ; nevertheless, its precise mechanism of action remains unknown. TXA has been applied through different modes of administration, including topically, orally, and intradermally, in the treatment of melasma 7–9 .…”

Section: Introductionmentioning

confidence: 99%

Tranexamic acid microinjections versus tranexamic acid mesoneedling in the treatment of facial melasma: A randomized assessor‐blind split‐face controlled trial

Poostiyan

Alizadeh

Shahmoradi

et al. 2023

J of Cosmetic Dermatology

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Background: Melasma is a hyperpigmentary disorder causing cosmetic disfigurement.We aimed to compare the efficacy and safety of tranexamic acid (TXA) microinjections with TXA mesoneedling for facial melasma.Methods: This randomized assessor-blind split-face controlled trial included patients with symmetric facial melasma. One side of the face received TXA (100 mg/ml) mesoneedling and the other side intradermal TXA microinjections. The interventions were repeated three times with 4-week intervals (weeks 0, 4, and 8). The primary outcome was improvement in modified Melasma Area and Severity Index (mMASI) 4 weeks after the final treatment session. Secondary outcomes were complications and patient satisfaction with the treatments evaluated by a visual analog scale (VAS).Results: All 27 patients included in the study were female (mean age: 44.22 ± 8.39 years).Both groups were comparable in terms of mMASI scores before and after treatment (standardized mean difference [SMD] = 0.32, 95% confidence interval [CI] −0.22; 0.85, p = 0.248 and SMD = −0.13, 95% CI −0.66; 0.40, p = 0.633, respectively). The mMASI score change from baseline was not different (SMD = −0.39, 95% CI −0.93; 0.15, p = 0.157). However, patient satisfaction was significantly higher with TXA mesoneedling (SMD = 0.77, 95% CI 0.21; 1.32, p = 0.007). Post-inflammatory hyperpigmentation occurred in one patient in the TXA mesoneedling group. Erythema, scaling, and edema were significantly higher with TXA mesoneedling (p < 0.001).Conclusions: TXA mesoneedling was comparable with TXA microinjection in the treatment of facial melasma, while patient satisfaction was significantly higher with TXA mesoneedling; however, the high frequency of complications occurring with this treatment should be taken into account.

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Oral tranexamic acid with fluocinolone-based triple combination cream versus fluocinolone-based triple combination cream alone in melasma: An open labeled randomized comparative trial

Cited by 38 publications

References 22 publications

Evaluation of Therapeutic Efficacy and Safety of Tranexamic Acid Local Infiltration in Combination with Topical 4% Hydroquinone Cream Compared to Topical 4% Hydroquinone Cream Alone in Patients with Melasma: A Split-Face Study

Evaluation of Therapeutic Efficacy and Safety of Tranexamic Acid Local Infiltration in Combination with Topical 4% Hydroquinone Cream Compared to Topical 4% Hydroquinone Cream Alone in Patients with Melasma: A Split-Face Study

Comparative efficacy and safety of tranexamic acid for melasma by different administration methods: A systematic review and network meta‐analysis

Tranexamic acid microinjections versus tranexamic acid mesoneedling in the treatment of facial melasma: A randomized assessor‐blind split‐face controlled trial

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