Comparison of oral versus topical tranexamic acid for treatment of melasma

Abstract

: Melasma is one of the most common causes of hyperpigmentation and is a prevalent cosmetic concern for patients. Tranexemic acid is an effective mode of treatment available in both oral and topical forms. : To evaluate and compare the therapeutic effectiveness of topical and oral tranexamic acid for the treatment of melasma. A total of 84 patients who presented to dermatology OPD with melasma were divided into two groups, namely A and B. Group A patients were treated with oral tranexamic acid 250 mg twice daily, and patients in Group B were treated with topical 5% tranexamic acid with follow-up every 4 weeks until 3 months. Among the oral treatment and topical patient groups, a statistically significant difference in the mean percentage of reduction in MASI score from baseline was observed at 12 weeks (61.31±9.48 for oral vs 52.64±8.03 for topical) with p<0.05. Systemic side effects like abdominal pain, nausea, and oligomenorrhea were observed with oral tranexemic acid, while topical side effects like erythema, skin irritation, and xerosis were observed with topical tranexemic acid treatment. Oral tranexamic acid gave a more promising result when compared to topical tranexamic acid. Despite having GI disturbances with oral tranexamic acid, it had more patient compliance and could be a promising therapeutic approach for melasma.