Effect of the use of tranexamic acid in the treatment of melasma
DOI:
https://doi.org/10.56294/saludcyt2024974Keywords:
Controlled Randomized Clinical Trials, Melasma, Pigmentation Disorders, Skin Pigmentation, Tranexamic Acid, Treatment OutcomeAbstract
Introduction: melasma is a skin condition that poses challenges due to its chronic nature and variable response to conventional therapies.
Objective: this study aimed to investigate the efficacy of tranexamic acid (TXA) in the treatment of melasma.
Methodology: a systematic review of randomized clinical trials was conducted to evaluate the efficacy of tranexamic acid (TXA) in the treatment of melasma. The literature search covered studies from 2019 to October 2023 in various electronic databases. Studies that met strict inclusion criteria were selected, prioritizing controlled and randomized clinical trials. The safety and efficacy of TXA in various formulations and routes of administration, such as oral, transepidermal, and intradermal, were evaluated.
Results: the findings demonstrated that TXA, in its different forms of administration, led to a reduction in the Melasma Area and Severity Index (MASI) scores, indicating improvements in skin pigmentation and dermal microcirculation. Reductions in epidermal melanin density and the number of pendulous melanocytes were observed. Additionally, the efficacy of TXA combined with other therapeutic agents, such as ascorbic acid or platelet-rich plasma, to improve melasma was highlighted.
Conclusion: TXA emerges as an effective therapeutic option in the treatment of melasma. Its ability to improve MASI scores suggests a positive effect on skin pigmentation and dermal microcirculation. However, challenges such as treatment tolerability and recurrence rates persist
References
1. Kabashima K, Honda T, Ginhoux F, Egawa G. The immunological anatomy of the skin. Nat Rev Immunol. 2019;16(4):25-37. DOI: 10.1038/s41577-018-0084-5
2. Leiter U, Keim U, Garbe C. Epidemiology of Skin Cancer: Update 2019. Springer Link. 2020; 12(3):231-45. DOI: 10.1007/978-3-030-46227-7_6
3. Arenas R. Dermatología. Atlas, diagnóstico y tratamiento. 7th ed. Madrid: McGraw-Hill Interamericana; 2015:78-92.
4. Cribier B. Histología de la piel normal y lesiones histopatológicas elementales. EMC - Dermatología. 2021; 55(2):213-25. DOI: 10.1016/S1761-2896(21)45139-3
5. Martín Pozo Y, Apolinario Castillo EC, Pérez Fleites D, Betancourt Pérez A, Alba Castellanos L, González Rodríguez R. Relación clínica-dermatoscópica-histológica de lesiones pigmentadas de piel sugestiva de melanoma. Acta Médica del Centro. 2022; 16(3):45-57.
6. Doolan B, Gupta M. Melasma. Aust J Gen Pract. 2021; 50(12):789-802. DOI: 10.31128/AJGP-05-21-6002
7. Artzi O, Horovitz T, Bar-Ilan E, Shehadeh W, Koren A, Zusmanovitch L, et al. The pathogenesis of melasma and implications for treatment. J Cosmet Dermatol. 2021; 20(11):1123-36. DOI: 10.1111/jocd.14382
8. Neagu N, Conforti C, Agozzino M, Marangi GF, Morariu SH, Pellacani G, et al. Melasma treatment: a systematic review. J Dermatolog Treat. 2022; 30(4):509-22. DOI: 10.1080/09546634.2021.1914313.
9. Dessinioti C, Lotti TM, Stratigos AJ, Damevska K, Katsambas A. Melasma. Springer International Publishing. 2023; 12(4):221-36. DOI: 10.4103/0019-5154.84722
10. Liu W, Chen Q, Xia Y. New mechanistic insights of melasma. Clin Cosmet Investig Dermatol. 2023; 40(11):135-48. DOI: 10.2147/CCID.S396272
11. Maddaleno A, Camargo J, Mitjans M, Vinardell M. Melanogenesis and melasma treatment. Cosmetics. 2021; 8(3):78-91. DOI: doi.org/10.3390/cosmetics8030082
12. Mahajan VK, Patil A, Blicharz L, Kassir M, Konnikov N, Gold M, et al. Medical therapies for melasma. J Cosmet Dermatol. 2022; 21(9):987-1000. DOI: 10.1111/jocd.15242
13. González V, Martí A, González N. Topical treatments for melasma and their mechanism of action. J Clin Aesthet Dermatol. 2022; 15(5):210-23.
14. Sarkar R, Bansal A, Ailawadi P. Future therapies in melasma: What lies ahead? Indian J Dermatol Venereol Leprol. 2020; 86(8):634-48. DOI: 10.4103/ijdvl.IJDVL_633_18
15. Pinho Cassiano D, Cavalcante Espósito AC, Hassun KM, Dantas de Andrade Lima MM, Vasconcelos de Andrade Lima E, Bartoli Miot LD, et al. Histological changes in facial melasma after treatment with triple combination cream with or without oral tranexamic acid and/or microneedling: A randomised clinical trial. IJDLV. 2022; 12(1):17-32. DOI: 10.25259/IJDVL_126_2021.
16. Konisky HB, Balazic EB, Jaller JAM, Khanna UM, Kobets KMM. Tranexamic acid in melasma: A focused review on drug administration routes. J Cosmet Dermatol. 2023; 16(1):45-58. DOI: 10.1111/jocd.15589
17. Batra J, Brar BK, Kumar S, Arora H. Tranexamic acid in melasma: Comparative evaluation of therapeutic efficacy of oral tranexamic acid versus its transepidermal administration. J Cutan Aesthet Surg. 2022; 15(4):321-36. DOI: 10.4103/JCAS.JCAS_237_20
18. Pazyar N, Molavi SN, Hosseinpour P, Hadibarhaghtalab M, Parvar SY, Dezfuly MB. Efficacy of intradermal injection of tranexamic acid and ascorbic acid versus tranexamic acid and placebo in the treatment of melasma: A split-face comparative trial. Health Sci Rep. 2022; 10(2):89-103. DOI: 10.1002/hsr2.537
19. Lueangarun S, Sirithanabadeekul P, Wongwicharn P, Namboonlue C, Pacharapakornpong S, Juntongjin P, et al. Intradermal Tranexamic Acid Injection for the Treatment of Melasma: A Pilot Study with 48-week Follow-up. J Clin Aesthet Dermatol. 2020; 13(8):455-69.
20. Menon A, Eram H, Kamath PR, Goel S, Babu AM. A Split Face Comparative Study of Safety and Efficacy of Microneedling with Tranexamic Acid versus Microneedling with Vitamin C in the Treatment of Melasma. Indian Dermatol Online J. 2020; 11(1):56-67. DOI: 10.4103/idoj.IDOJ_22_19
21. Feng X, Su H, Xie J. The efficacy and safety of microneedling with topical tranexamic acid for melasma treatment: A systematic review and meta-analysis. J Cosmet Dermatol. 2023; 16(3):213-27.
22. Zhang C, Wu T, Shen N. Effect of platelet-rich plasma combined with tranexamic acid in the treatment of melasma and its effect on the serum levels of vascular endothelial growth factor, endothelin-1 and melatonin. Pak J Med Sci. 2022; 38(8):1025-35. DOI: 10.1111/jocd.15965
23. Kwon SH, Na JI, Choi JY, Park KC. Melasma: Updates and perspectives. Wiley. 2019; 12(3):89-105. DOI: 10.1111/exd.13844
24. McKesey J, Tovar-Garza A, Pandya A. Melasma Treatment: An Evidence-Based Review. Springer Link. 2020; 15(1):67-79. DOI: 10.1007/s40257-019-00488-w
Published
Issue
Section
License
Copyright (c) 2024 Zenia Batista Castro, Grace Anabel Tituaña Ortega (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.