Oral Tranexamic Acid for the Treatment of Melasma: A Review

Harini R. Bala, Senhong Lee, Celestine Wong, Amit G. Pandya, Michelle Rodrigues

Research output: Contribution to journalReview article

9 Scopus citations

Abstract

BACKGROUND: Melasma is a common acquired disorder of hyperpigmentation that commonly affects those with skin of color. Tranexamic acid (TXA) is a novel treatment for melasma that has a multimodal mechanism of action.

OBJECTIVE: To provide a comprehensive review of the literature regarding the evidence on the mode of action, safety profile, and efficacy of TXA in the treatment of melasma.

MATERIALS AND METHODS: The literature was searched for publications on TXA in the treatment of melasma using MEDLINE, Scopus, and Google Scholar.

RESULTS: Oral TXA has clearly demonstrated the efficacy for melasma in Asian skin, even in low doses (e.g., 500 mg daily) over short periods (8-12 weeks). It is also a safe therapeutic option, which is easy to administer with few and mild side effects. Studies have shown that TXA does not increase the thromboembolic risk, although patients should be screened carefully for contraindications and risk factors prior to commencement of the therapy.

CONCLUSION: Oral TXA is a safe and efficacious treatment for refractory melasma. It should be considered in cases that are unresponsive to topical hydroquinone and combination topical therapy over a period of approximately 12 weeks and without contraindications to oral TXA.

Original languageEnglish (US)
Pages (from-to)814-825
Number of pages12
JournalDermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
Volume44
Issue number6
DOIs
Publication statusPublished - Jun 1 2018

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ASJC Scopus subject areas

  • Surgery
  • Dermatology

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