Efficacy and Safety of Tranexamic Acid in Melasma: A Meta-analysis and Systematic Review

Kim, Hyun Jung; Moon, Seok Whan; Cho, Sang Hyun; Lee, Jeong Deuk; Kim, Hei Sung

doi:10.2340/00015555-2668

Cited by 103 publications

(98 citation statements)

References 21 publications

(74 reference statements)

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“…Nausea was reported equally in both groups. According to previous reports, evidence of systemic fibrinolytic suppression and thrombogenic effect was not found in long‐term systemic treatment with TA in melasma patients . Although we did not perform the blood coagulation tests, evidence of venous thrombosis was not found in TA group in our study.…”

Section: Discussioncontrasting

confidence: 54%

A Prospective Randomized Controlled Study of Oral Tranexamic Acid for the Prevention of Postinflammatory Hyperpigmentation After Q‐Switched 532‐nm Nd:YAG Laser for Solar Lentigines

et al. 2019

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Background and Objectives Q‐switched (QS) 532‐nm Nd:YAG laser is one of the treatment options for solar lentigines (SLs). However, the high incidence of postinflammatory hyperpigmentation (PIH) is concerning, especially in dark‐complexioned skin. Tranexamic acid (TA) can decrease melanogenesis and has been used to treat melasma. The aim of this study is to evaluate the efficacy and safety of oral TA for PIH prevention and clearance in patients with SL treated with QS 532‐nm Nd:YAG laser. Study Design/Materials and Methods Forty patients with SL treated with QS 532‐nm Nd:YAG laser were enrolled in this randomized controlled trial. They were randomly assigned to be receive oral TA 1,500 mg daily or placebo for 6 weeks. Results were evaluated by blinded investigators using digital photographs, dermatoscopy, colorimetry, physician grading scores, and patient satisfaction scores at baseline, 2nd, 4th, 6th, and 12th weeks. Results The incidence of PIH, relative melanin value, lightness index, and clinical improvement scores were not significantly different between the two groups. However, the TA group had a significantly lower incidence of dermatoscopic finding of pigmented granules, which correspond to PIH at 6th and 12th weeks (P = 0.038 and 0.013, respectively). Homogenous light brown pigmentation under dermatoscopy was significantly associated with higher clinical improvement. Conclusions Oral TA therapy starting at the first day postlaser treatment is not effective for PIH prevention after QS 532‐nm Nd:YAG laser in SL. However, PIH clearance, as assessed dermatoscopically, is significantly improved by oral TA at 6th and 12th week. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

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Section: Discussioncontrasting

confidence: 54%

A Prospective Randomized Controlled Study of Oral Tranexamic Acid for the Prevention of Postinflammatory Hyperpigmentation After Q‐Switched 532‐nm Nd:YAG Laser for Solar Lentigines

et al. 2019

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“…The depigmenting property this agent has been extensively studied, particularly in the field of hyperpigmentation disorders, such as melasma (Zhang et al, 2018). As a novel agent, different preparations and concentrations have been used, either alone or as an adjunctive treatment, in multiple clinical trials, producing variable results (Kim, Moon, Cho, Lee, & Sung Kim, 2017;Zhang et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Randomized control trial outcomes of tranexamic acid combination serum as a depigmenting agent for the use in healthy individuals

Anwar

Wahab

Widita

et al. 2019

Dermatologic Therapy

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To compare the effectiveness of tranexamic acid (TA) combination serum with hydroquinone, the gold standard in whitening agents for healthy populations. This was a three‐arm randomized controlled trial. The subjects were divided into three groups: the first group received 3% TA combination serum (3% TA, 4% galactomyces ferment filtrate, 2% niacinamide, and 4% alpha arbutin), the second group received 2% TA combination serum, and the third group received 4% hydroquinone. One milliliter of each serum was applied on three holes: Hole A, which was located 4 cm from the left cubital fossa, Hole B, which was located 4 cm from the first hole, and Hole C, which was located 4 cm from the right cubital fossa. The skin brightness and pigmentation intensity were evaluated each week for 4 weeks using a chromameter. A total of 44 subjects were recruited for this study. All groups showed a significant improvement in skin brightness and pigmentation intensity after 4 weeks (p < .001). There were no differences between the treatment groups and hydroquinone (p > .05). TA serum (2 and 3%) combined with 4% galactomyces ferment filtrate, niacinamide, and alpha arbutin is an effective depigmenting agent.

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“…Melasma may impose major psychological and emotional burden on patients and affect their quality of life. Common therapeutic approaches for melasma include topical hydroquinone (HQ), azelaic acid, steroids, chemical peels, and lasers, most of which could not induce remarkable and constant satisfying outcomes [2, 3, 7]. …”

Section: Introductionmentioning

confidence: 99%

Evaluation of Therapeutic Efficacy and Safety of Tranexamic Acid Local Infiltration in Combination with Topical 4% Hydroquinone Cream Compared to Topical 4% Hydroquinone Cream Alone in Patients with Melasma: A Split-Face Study

Tehranchinia

Saghi

Rahimi

2018

Dermatology Research and Practice

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Introduction Melasma is an acquired pigmentary disorder characterized by hyperpigmented macules and/or patches affecting sun-exposed skin. Tranexamic acid (TA) can reduce melanin content of epidermis. Thus, we conducted this study to evaluate the efficacy and safety of tranexamic acid local infiltration in combination with topical 4% hydroquinone cream compared to topical 4% hydroquinone cream alone in patients with melasma. Material and Methods This study was a prospective assessor- and analyst-blind, randomized split-face clinical trial which was performed on patients with bilateral malar epidermal melasma. A total of 55 patients were enrolled, and each side of their face was randomly allocated to either TA+HQ or HQ alone treatment. The MASI score was applied as an objective measurement to compare two treatment groups. The patient's satisfaction of melasma treatment was evaluated using a four-scale grading, as well. Results The mean of MASI score in week 16 decreased in both groups significantly (p < 0.01). The therapeutic outcomes were significantly better in TA+HQ group than HQ group (p=0.001). Patients satisfaction with treatment was significantly higher in the TA + HQ group. The difference between the two groups regarding side effect occurrence was not statistically significant. Conclusion Addition of tranexamic acid injections to conventional hydroquinone therapy can increase the efficacy of topical treatment. This trial is registered with IRCT2015110324865N1.

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Efficacy and Safety of Tranexamic Acid in Melasma: A Meta-analysis and Systematic Review

Cited by 103 publications

References 21 publications

A Prospective Randomized Controlled Study of Oral Tranexamic Acid for the Prevention of Postinflammatory Hyperpigmentation After Q‐Switched 532‐nm Nd:YAG Laser for Solar Lentigines

A Prospective Randomized Controlled Study of Oral Tranexamic Acid for the Prevention of Postinflammatory Hyperpigmentation After Q‐Switched 532‐nm Nd:YAG Laser for Solar Lentigines

Randomized control trial outcomes of tranexamic acid combination serum as a depigmenting agent for the use in healthy individuals

Evaluation of Therapeutic Efficacy and Safety of Tranexamic Acid Local Infiltration in Combination with Topical 4% Hydroquinone Cream Compared to Topical 4% Hydroquinone Cream Alone in Patients with Melasma: A Split-Face Study

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