Oral tranexamic acid (TA) in the treatment of melasma: A retrospective analysis

Lee HC1, Thng TG2, Goh CL2.



Melasma is a common pigmentary disorder among Asians and treatment is challenging. Oral tranexamic acid (TA) has emerged as a potential treatment for refractory melasma. Large-scale studies on its use, outcomes, and safety are limited.


We sought to evaluate treatment outcomes and adverse effects of oral TA in melasma in an Asian population.


We conducted a retrospective analysis of patients who received oral TA for melasma in a tertiary dermatologic center from January 2010 to June 2014.


In all, 561 patients (91.4% female, 8.6% male) were enrolled. Median duration of treatment was 4 months. The majority (503 [89.7%]) improved, 56 (10.0%) had no improvement, and 2 (0.4%) worsened. Patients without family history of melasma had better response rates than those with family history (90.6% vs 60.0%, P = .01). Of the 503 who improved, response was seen within 2 months of TA initiation, with a relapse rate of 27.2%. Adverse events occurred in 40 (7.1%). Most were transient, but 1 developed deep vein thrombosis requiring prompt discontinuation. She was later given the diagnosis of familial protein S deficiency.


This was a retrospective study.


Oral TA may be an effective adjunct for refractory melasma. Careful screening for personal and familial risk factors for thromboembolism should be done before initiation.


angiogenesis; chloasma; facial pigmentation; melanogenesis; melasma; tranexamic acid

Acerca de Editores PIEL-L

Mesa de redacción de Piel Latinoamericana. Donde recibimos casos, aportes e información de interés para la comunidad latinoamericana dermatólogica

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