Topical tranexamic acid as a promising treatment for melasma

Bahareh Ebrahimi, Farahnaz Fatemi Naeini, Bahareh Ebrahimi, Farahnaz Fatemi Naeini

Abstract

Background: In recent times, tranexamic acid (TA) is claimed to have whitening effects especially for ultraviolet-induced hyperpigmentation including melasma. The aim of our study was to evaluate the efficacy and safety of topical solution of TA and compare it with combined solution of hydroquinone and dexamethasone as the gold standard treatment of melasma in Iranian women.

Materials and methods: This was a double-blind split-face trial of 12 weeks which was conducted in Isfahan, Iran. Fifty Iranian melasma patients applied topical solution of 3% TA on one side of the face, and topical solution of 3% hydroquinone + 0.01% dexamethasone on the other side two times a day. The Melasma Area and Severity Index (MASI) and the side effects were evaluated at baseline and every 4 weeks before and after photographs to be compared by a dermatologist were taken. The patient satisfaction was documented at week 12.

Results: A repeated measurement analysis was used to evaluate the changes in the MASI score before and after treatments. A significant decreasing trend was observed in the MASI score of both groups with no significant difference between them during the study (P < 0.05). No differences were seen in patients' and investigator's satisfaction of melasma improvement between two groups (P < 0.05). However, the side effects of hydroquinone + dexamethasone were significantly prominent compared with TA (P = 0.01).

Conclusion: This study's results introduce the topical TA as an effective and safe medication for the treatment of melasma.

Keywords: Melanosis; dexamethasone; hydroquinone; therapy tranexamic acid.

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Changes of Melasma Area and Severity Index score of two groups
Figure 2
Figure 2
Representative the side which was treated with hydroquinone + dexamethasone (a: At baseline, b: After 12 weeks)
Figure 3
Figure 3
Representative the side which was treated with tranexamic acid (a: At baseline, b: After 12 weeks)
Figure 4
Figure 4
Patient self-assessment of improvement at week 12. Patients were asked to grade their overall improvement as 1 = >75% lightening (excellent), 2 = 51-75% (good), 3 = 26-50% (fair), and 4 = 0-25% lightening (poor)
Figure 5
Figure 5
Physician assessment of improvement at week 12 based on the patients photos. Physician were asked to grade their overall improvement as 1 = >75% lightening (excellent), 2 = 51-75% (good), 3 = 26-50% (fair), and 4 = 0-25% lightening (poor)

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Source: PubMed

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