Efficacy of Oral Tranexamic Acid in the Treatment of Melasma: A Pilot Study
Background: Melasma a common skin pigmentary disorder poses a great challenge to clinicians due to unsatisfactory results and high recurrence rate. Many treatment modalities have been tried by clinicians without significant improvement in the lesion. Methods: This cross sectional study was done on 90 patients including both male and female and were diagnosed with moderate to severe melasma. TA 250 mg (thyrodin) bid for six months was prescribed along with topical sunscreen. Digital photography was performed at the first visit and at subsequent visits. The effects of treatment were evaluated by two dermatologists independently. Results were assed clinically and photographically.
Result: 90 patients with moderate to severe melasma were enrolled in the study. The average age was 36 years. 44patients (48.8%) had good improvement, 25 patients (27.7%) had excellent improvement and 17 patients (18.8%) had fair improvement and 4 patients (4.4%) had no improvement.
Three patients complained about gastric upset. None of the patients had serious systemic side effects, only few had oligomenorrhoea, palpitation. Patient’s satisfaction was similarly noted. Conclusion: oral administration of TA is effective and safe treatment for melasma.
2. Grimes PE. Melasma. Etiologic and therapeutic considerations. Arch Dermatol 1995; 131:1453-7.
3. Grimes PE. Management of hyperpigmentation in darker racial ethnic groups. Semin Cutan Med Surg 2009; 28:77-85.
4. Gupta AK, Gover MD, Nouri K, Taylor S. Treatment of melasma: A review of clinical trials. J Am Acad Dermatol 2006; 55:1048-65.
5. Sanchez NP, Pathak MA, Sato S et al. Melasma: A clinical, light microscopic, ultrastructural, and immunofluorescence study. J Am Acad Dermatol 1981;4:698‑710.
6. Prignano F, Ortonne J, Buggiani G, Lotti T. Therapeutical approaches in melasma. Dermatol Clin 2007; 25:337-342.
7. Romero C, Aberdam E, Larnier C, Ortonne JP.Retinoic acid as modulator of UVB-induced melanocyte differentiation..J Cell Sci 1994;107:1095-1103.
8. Angsuwarangsee S, Polnikorn N. Combined ultra-pulse CO2 laser and Q-switched Alexandrite laser compared with Q-switched Alexandrite laser alone for refractory melasma.Dermatol Surg 2003; 29:5964.
9. Prignano F, Ortonne J, Buggiani G, Lotti T. Therapeutical approaches in melasma. Dermatol Clin 2007; 25:337-342.
10. Maeda K, Tomitab Y. Mechanism of the inhibitory effect of tranexamic acid on melanogenesis in cultured human melanocytes in the presence of keratinocyte conditioned medium. J Health Sci 2007;53:389-96.
Maeda K, Naganuma M. Topical trans-4 amino methyl cyclo hexanecarboxylic acid prevent ultraviolet radiation-induced pigmentation. J Photochem Photobiol 1998; 47:136-41.
11. Pawaskar MD, Parikh P, Markowski T et al. Melasma and its impact on health- related. Quality of life in Hispanic women. J Dermatolog Treat 2007; 18:5-9.
12. Dunn CJ, Goa KL. Tranexamic acid: a review of its use in surgery and other indications. Drugs 1999; 57:1005-1032
13. Prignano F, Ortonne J, Buggiani G, Lotti T. Therapeutical approaches in melasma. Dermatol Clin 2007; 25:337-342.
14. Nouri K, Bowes L, Chartier T, Romagosa R, Spencer J.Combination treatment of melasma with pulsed CO2 laser followed by Q-switched Alexandrite laser: a pilot study. Dermatol Surg 1999; 25:494-497.
15. Lee JH, Park JG, Lim SH et al. Localized intradermal microinjection of tranexamic acid for treatment of melasma in Asian patients: a preliminary clinical trial. Dermatol Surg 2006; 32:626-631.
16. Nijor T. Treatment of melasma with tranexamic acid. Clin Res 1979; 13:3129-31.
17. Wu S, Shi H, Wu H et al. Treatment of melasma with oral administration of tranexamic acid. Aesthetic Plast Surg 2012; 36:964-70.
18. Safoora .A, Riffat .N. Oral tranexamic acid in treatment of melasma in Pakistani population: a pilot study. Journal of Pakistan Association of Dermatologists 2014;24 (3):198-203.
19. Karn D, K C S, Amatya A et al. Oral tranexamic acid for the treatment of melasma. Kathmandu Univ Med J 2012;10:40-3.
20. Wu S, Shi H, Wu H et al. Treatment of melasma with oral administration of tranexamic acid. Aesthetic Plast Surg. 2012; 36:964-70.
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