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Efficacy of Tranexamic Acid Containing Oral Medication on Melasma

Jung Won Shin, M.D., Sun Young Huh, M.D., Jeong Bok Jeong, R.N., Kyoung Chan Park, M.D.
Department of Dermatology, Seoul National University College of Medicine, Seoul,
Seoul National University Bundang Hospital, Seongnam, Korea

Background: Melasma causes considerable cosmetic disfigurement and none of the existing treatment modalities are satisfactory. Recently tranexamic acid has been reported to reduce hyperpigmentation in patients with melasma.
Objective: The purpose of the study was to evaluate the efficacy and safety of tranexamic acid containing oral medication for the treatment of melasma.
Methods: Forty-five female volunteers who had been diagnosed with melasma were enrolled in the present study. Patients were instructed to take medication for 8 weeks. The melanin index (MI) and erythema index (EI) were measured at baseline, and at 4 and 8 weeks. The melasma area and severity index (MASI) was scored at 0, 4, and8 weeks. Self-satisfaction and safety evaluations were also performed at each visit.
Results: The mean MI measured on the lesional skin was decreased at 4 and 8 weeks compared with baseline (p£¼0.01 for both). The mean EI measured on the lesional skin and the MASI also showed a significant decrease from baseline to 8 weeks (p£¼0.001 for EI and p=0.020 for MASI). Based on self-assessment, 39.5% of the patients were very satisfied, 44.2% were satisfied, and 11.6% felt moderate improvement after 8 weeks of medication; only 2 patients (4.7%) were dissatisfied. Thus, £¾80% of patients were satisfied with the medication. Adverse effects were minimal and two patients dropped out of the study due to drug-related urticaria and unexpected pregnancy.
Conclusion: Tranexamic acid-containing oral medication is an effective and safe therapeutic modality for the
treatment of melasma. (Korean J Dermatol 2011;49(7):565¡­571)
Key Words: Erythema index (EI), Melanin index (MI), Melasma, Tranexamic acid


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