Effectiveness of Topical 5% Tranexamic Acid in the Treatment of Melasma

Abstract

Objective: To evaluate the efficacy and safety of topical 5% tranexamic acid in the treatment of moderate to severe melasma. 

Study Design: Prospective interventional study 
Place and Duration of Study: This study was conducted at the Department of Dermatology, Lady Reading Hospital, Peshawar, between November 6, 2021, and May 6, 2022. 

Methods: After giving informed consent, 99 patients aged between 18 - 50 years of both genders with a clinically diagnosed moderate to severe melasma were enrolled. Topical 5% tranexamic acid cream, which was put daily in two applications during one week, was used to treat patients over 12 weeks, as well as to use broad-spectrum sunscreen (SPF 50+). The effectiveness of the treatment was measured by the Melasma Area and Severity Index (MASI) score at baseline and week 12. Physician Global Assessment (PGA) and patient satisfaction were taken as secondary outcomes. Safety was assessed by conducting clinical check-ups and reporting of adverse events.  

Results: The mean age of participants was 32.25 ± 9.65 years, with a female predominance (57.6%). Overall clinical effectiveness was observed in 63 patients (63.6%) following 12 weeks of treatment. No statistically significant association was found between treatment response and age (p=0.61), gender (p=0.90), or disease duration (p=0.27). Topical tranexamic acid was well tolerated, and no major adverse effects were reported during the study period. 

Conclusion: Topical 5% tranexamic acid is an effective and safe treatment option for moderate to severe melasma. Its favorable efficacy, good tolerability, and lack of significant influence by demographic or disease-related factors make it a useful therapeutic alternative in routine clinical practice.