Therapeutic Effects of Topical Tranexamic Acid in Comparison with Hydroquinone in Treatment of Women with Melasma

Abstract

IntroductionFew studies have focused on therapeutic as well as side effects of tranexamic acid (TXA) as a topical drug compared to other topical drugs in treating melasma. The present study aimed to assess and compare the beneficial therapeutic effects and also side effects of local TXA in comparison with hydroquinone in treating women with melasma.MethodsThis randomized double-blinded clinical trial was performed on 60 women who suffered from melasma and were referred to the skin disorders clinic at the Rasoul-e-Akram hospital in Tehran in 2015. The patients were then randomly assigned via computerized randomization to two groups: group A received TXA%5 (topically twice a day for 12 weeks in the location of the melasma) and group B (received hydroquinone 2% with the same treatment order). Prior to intervention and at 12 weeks after intervention, the intensity and extension of melasma were assessed based on the Melasma Area and Severity Index (MASI) scoring method.ResultsThe mean MASI score in both treatment groups decreased considerably after completion of treatment and was not significant between the two groups. No side effects were detected in group A, but 10% of those in group B complained of drug-related side effects including erythema and skin irritation (p = 0.131). Regarding the level of patient satisfaction, the patients in group A had a significantly higher level of satisfaction level of 33.3% compared with 6.7% in group B (p = 0.015) (Fig. 9). Multivariate linear regression modeling with the presence of age, history of systemic disorder, drug history, and family history of melasma demonstrated no difference in the mean MASI between the two groups.ConclusionTopical use of TXA significantly reduced both melanin level and MASI score. Given its high efficiency and low drug side effects, this regimen results in high patient satisfaction compared with topical hydroquinone. IRCT code: IRCT2016040627220N2.

Randomized control trial outcomes of tranexamic acid combination serum as a depigmenting agent for the use in healthy individuals

“…These data suggest that in addition to treating hyperpigmentation disorders, TA is an effective depigmenting agent in healthy individuals, as opposed to the classical view that TA is only effective in the treatment of ultraviolet-induced pigmentation (Atefi et al, 2017).…”

“…These results are further supported by the result of the Pearson's correlation analysis, which suggests a statistically significant trend toward improvement in all groups, with the largest R value found in the 2% TA group. These data suggest that in addition to treating hyperpigmentation disorders, TA is an effective depigmenting agent in healthy individuals, as opposed to the classical view that TA is only effective in the treatment of ultraviolet‐induced pigmentation (Atefi et al, ).…”

Popular over‐the‐counter cosmeceutical ingredients and their clinical efficacy

“…5% TXA or 2% hydroquinone was applied twice daily, and melasma was evaluated at baseline at 12 weeks using MASI scoring method. 35 Melanin level and the mean MASI score decreased considerably in both groups, with no significant differences between the groups. 35 Additionally, fewer side effects such as erythema and irritation were reported in the TXA group.…”

“…Atefi et al . studied 5% TXA to be effective in treating melasma vs. hydroquinone in a 12‐week randomized, double‐blind trial ( n = 60) . Hydroquinone is the gold standard for treating melasma.…”

“…34 Atefi et al studied 5% TXA to be effective in treating melasma vs. hydroquinone in a 12-week randomized, double-blind trial (n = 60). 35 Hydroquinone is the gold standard for treating melasma. 5% TXA or 2% hydroquinone was applied twice daily, and melasma was evaluated at baseline at 12 weeks using MASI scoring method.…”