Efficacy of Topical Tranexamic Acid in Treatment of Melasma

Yoo, Jisook; Ahn, Hyosang; Kim, Min Soo; Jue, Mihn Sook; Choi, Kwang Hyun

Abstract

BACKGROUND
Tranexamic acid (TXA), a plasmin inhibitor, has been used orally or via intradermal injection to treat melasma; however, there are limited studies regarding efficacy and safety of topical application of TXA.
OBJECTIVE
The purpose of this study is to evaluate the efficacy and safety of topical tranexamic acid in treatment of melasma.
METHODS
We enrolled 25 female volunteers with melasma in a split-face trial lasting 10 weeks. Patients were instructed to apply cream containing tranexamic acid on only the right side of their face every night without application on the other side. The pigmentary index (PI) using API-100 and Melasma Area and Severity Index (MASI) were measured at 0, 5, and 10 weeks. Patient satisfaction questionnaires and safety evaluation by a dermatologist were performed at each follow-up visit.
RESULTS
Twenty-five patients completed the study, and we noted reduction in both, mean MASI and PI scores. The mean MASI score was 7.75±5.10 at baseline, 6.72±4.25 at week 5, and 6.26±3.76 at week 10 p=0.008). The mean PI score on the right side of the face was 40.56±22.51 at baseline, 29.96±16.62 at week 5, and 26.88±15.97 at week 10. The PI on the right side of the face decreased by 26.1% (p<0.001) at week 5 and 33.7% (p<0.001) at week 10 compared to the baseline. Mean PI score on the unaffected side of the face was 40.56±22.60 at baseline, 37.48±17.79 at week 5, and 34.68±16.44 at week 10, although this reduction was not statistically significant (p=0.146). Only mild irritation occurred in two patients, no other serious adverse events were noted, and patients were generally satisfied with their results.
CONCLUSION
Topical TXA can be considered a safe and effective option in the treatment of melasma.