Oral Tranexamic Acid in the Treatment of Melasma (Chloasma, Pregnancy mask): a Summary

• Oral tranexamic acid taken orally is effective in the treatment of melasma (chloasma, pregnancy mask) refractory to topical combination treatment. These results are supported by evidence from previous studies frm Japan and South Korea.
• Tranexamic Acid (trans-4-aminomethylcyclohexanecarboxylic acid) is an anti-fibrinolytic agent which inhibits the activation of plasminogen by reversible blockade of lysine-binding molecules on plasminogen).
• Tranexamic acid take orally lightens melasma lesions by interfering with the interaction between keratinocytes and melanocytes. However, it remains a mystery as the the lightening effect of tranexamic acid in melasma. Clinicopathological data show a reduction of dermal blood vessels in the melasma lesions of subjects having responded to orally taken tranexamic acid.
• Tranexamic acid could lighten melasma by modulating secreted factors which might be important for angiogenesis and melanogenesis (NoS, VEGF…)

Contributors:

Dr Christophe HSU – dermatologist. Geneva, Switzerland

Source of Information: Goh BK. Melasma, Topicals and Beyond. NSC Dermatology Update 2012, Singapore