Oral tranexamic acid safe, effective for moderate-to-severe melasma
Oral tranexamic acid (TA) may help improve moderate-to-severe melasma with negligible side effects, according to a recent study.
Of the 44 patients included, 39 completed the study. Reduction in the modified Melasma Area and Severity Index (mMASI) score at 3 months was greater in the TA group than in the control group (49 percent vs 18 percent). Patients with severe melasma benefitted more from treatment than those with moderate melasma.
Three months after treatment cessation, reduction in mMASI score remained higher in the TA cohort compared with the baseline visit vs that in the placebo arm (26 percent vs 19 percent). There were no adverse events in either group.
This single-centre study enrolled predominantly Hispanic women. Patients with moderate-to-severe melasma received 250-mg TA or placebo capsules twice daily for 3 months and sunscreen, followed by 3 months of treatment with sunscreen only. The mMaSI score was the primary outcome measure.
In another study, researchers concluded that topical TA was effective for melasma, adding that suppression of endothelin-1 could be one of the mechanisms of action of TA on melasma. [Clin Exp Dermatol 2016;41:480-485]
A recent systematic review and meta-analysis has shown that TA is effective and safe, either alone or as an adjuvant to routine treatment modalities for melasma. [Acta Derm Venereol 2017;97:776-781]
“Melasma is a common pigmentary disorder that is often difficult to treat,” according to the investigators of the current study. “TA has emerged as a promising treatment for melasma; however, few controlled studies exist.”