Study of oral tranexamic acid, topical tranexamic acid, and modified Kligman's regimen in treatment of melasma

J Cosmet Dermatol. 2020 Jun;19(6):1456-1462. doi: 10.1111/jocd.13430. Epub 2020 Apr 28.

Abstract

Background: Melasma is a pigmentary disorder affecting mainly face . Various treatment modalities available as topicals, superficial chemical peels and lasers but none till date gives promising results, until date quest for the best treatment modality is on.

Aim: To study the effect of oral and topical Tranexamic acid (TXA) and modified Kligman's regimen in treatment of melasma.

Method: Patients having melasma were enrolled after consent for voluntary participation. A detailed history and clinical examination was done. Total 60 patients were enrolled and randomized in three groups, 20 received oral TXA 250 mg twice daily, 20 topical TXA and 20 received modified Kligman's regimen for 8 weeks along with sunscreen MASI(Melasma area severity index) was calculated at baseline, at end of 4 & 8 weeks. MASI score was compared with that at the end of the study. Based on reduction in mean MASI the therapeutic response was graded. Pre and post treatment photographs was also compared. Statistical analysis done by using student square T test , ANOVA And TUKEY test.

Results: Reduction in MASI score was observed in all the groups but greater reduction in MASI score with modified Kligman's regimen by 30% followed with oral TXA by 25% reduction and least with topical TXA by 5%.

Conclusion: Although modified Kligman's regimen is comparatively more efficient but due to its side effects in long term usage oral tranexamic acid could be a promising therapeutic approach for melasma.

Keywords: MASI score; melasma; modified Kligman's regimen; tranexamic acid.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Cutaneous
  • Administration, Oral
  • Adolescent
  • Adult
  • Drug Combinations
  • Female
  • Fluocinolone Acetonide / administration & dosage
  • Fluocinolone Acetonide / adverse effects
  • Fluocinolone Acetonide / analogs & derivatives*
  • Follow-Up Studies
  • Humans
  • Hydroquinones / administration & dosage*
  • Hydroquinones / adverse effects
  • Male
  • Melanosis / diagnosis
  • Melanosis / drug therapy*
  • Middle Aged
  • Prospective Studies
  • Severity of Illness Index
  • Sunscreening Agents / administration & dosage
  • Tranexamic Acid / administration & dosage*
  • Tranexamic Acid / adverse effects
  • Treatment Outcome
  • Tretinoin / administration & dosage*
  • Tretinoin / adverse effects
  • Young Adult

Substances

  • Drug Combinations
  • Hydroquinones
  • Sunscreening Agents
  • Fluocinolone Acetonide
  • Tretinoin
  • Tranexamic Acid
  • fluocinolone
  • hydroquinone