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

BACKGROUND

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.

OBJECTIVE

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

METHODS

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

RESULTS

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.

LIMITATIONS: This was a retrospective study.

CONCLUSION

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.