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Treating Melasma With Tranexamic Acid

A study has sought to compare the efficacy of different routes of administration of tranexamic acid (TXA) in the treatment of melasma.

Tranexamic acid is used orally, intravenously, topically and intradermally to treat melasma – a condition in which dark pigmentation develops in the skin. The comparative efficacy of the different routes of administration were investigated for the first time in a study published in Clinical and Experimental Dermatology.

In the study, 100 patients with melasma, aged between 18 and 55 years, were randomly assigned to one of two groups. Group A received oral TXA twice daily, while Group B received intradermal microinjections of TXA once a month.

The treatment continued for three months in both groups, and 39 patients from Group A and 41 patients from Group B completed the study.

Percentage reduction in baseline Melasma Area and Severity Index (MASI) was assessed at four-week intervals, and response was scored as ‘very good’ (more than 75 percent reduction), ‘good’ (50 to 75 percent reduction), ‘moderate’ (25 to 50 percent reduction), ‘mild’ (up to 25 percent reduction) or ‘no response’.

‘Very good’ response was seen in 25 patients in Group A and 32 patients in Group B. ‘Good’ response was seen in 14 patients in Group A and nine patients in Group B.

The study found that both treatment methods were equally effective, with an average reduction of MASI of 77.96 in Group A and 79.00 in Group B after 12 weeks.

The main adverse effects were mild epigastric discomfort, hypomenorrhea, headache and injection site pain, which did not warrant discontinuation of treatment. Two patients in Group A had relapses at 24 weeks.

The study concluded that tranexamic acid appears to be an effective and safe treatment for melasma, irrespective of its route of administration.

Read more about recent research in melasma.


Sharma, R. et al. (June 25, 2017.) Therapeutic efficacy and safety of oral tranexamic acid and that of tranexamic acid local infiltration with microinjections in patients with melasma: a comparative study. Clinical and Experimental Dermatology. DOI: 10.1111/ced.13164.

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