Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Melasma is a condition characterized by increased pigmentation and blood vessel formation, typically observed in women of childbearing age. The etiology of melasma remains unclear, however, it frequently manifests in sun‐exposed regions of the face. Contributing factors encompass genetic predisposition, ultraviolet (UV) radiation exposure, familial background, elevated levels of estrogen/progesterone, and specific pharmaceuticals. Diverse modalities have been employed to address this issue, yielding varying outcomes, yet the results are not encouraging. Tranexamic acid (TXA) is an off‐label treatment for melasma that functions as a plasmin inhibitor. TXA can be administered via oral, topical, or intralesional routes. To determine the optimal dose, safety and efficacy of oral tranexamic acid for the treatment of melasma. A comprehensive PubMed/Medline, Google scholar and Cochrane database was searched using the keywords tranexamic acid and melasma. Twenty nine articles were included for this study. Oral TXA in the dose range of 500‐1500 mg per day was studied in a variety of randomized controlled trials and have been compared with several traditional treatments. Overall, MASI scores improved and reduction of dermal blood flow was seen on histopathological examination. Oral TXA was found to be the most effective, especially in cases of refractory melasma: however, it causes gastro‐intestinal upset and hypomenorrhea in few patients. Due to its pro‐thrombotic nature, past history of any thromboembolism and deep vein thrombosis episode or family history must be evaluated before prescribing the patients. Intralesional injections of TXA and microneedling with topical TXA were found to be effective alternatives to oral treatment.
How to cite this article:
Suneel Singh Sengar, Vandna Singh, Shivank Shrivastava and Sourabh Dwivedi. Oral Tranexamic Acid in Melasma: A Novel Therapeutic Approach.
DOI: https://doi.org/10.36478/10.59218/makrjms.2024.5.86.91
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2024.5.86.91