Use of tranexamic acid in melasma
Journal Title: Український журнал дерматології, венерології, косметології - Year 2019, Vol 0, Issue 3
Abstract
Tranexamic acid (TA) is an old drug used for a long time to treat or prevent excessive blood loss. In the beginning of the 1950s it was discovered that the amino acid lysine was able to inhibit activation of plasminogen, but the effect was too weak to be a candidate for the treatment of fibrinolytic haemorrhagic conditions. The first mention of TA in dermatology was in 1979 in actinic prurigo, with good results. Later it was demonstrated in vitro that TA was able to block melanogenesis. During the 2010’s more and more trials were published, assessing its efficacy in melasma, but also in erythrotelangiectasic rosacea. First, systemic TA was prescribed, but soon, because of the rare but severe complications susceptible of occurring, topical way was tested, giving similar results without risk of side effects. The particular interest of TA in the management of melasma is due to that it displays an activity at various levels. First, TA was shown to downregulate the activity of mast cells and consequently the release of histamine. Following the review of the currently available literature concerning the use of TA in melasma, it appears that this active ingredient permits achieving a good efficacy in this indication where there is no satisfactory therapy, with minor side effects. There are mainly three modalities of treatment of melasma with TA: oral administration and intradermal and topical applications. From the literature reviewed, it appears that the best results can be achieved by intradermal administration of TA (4 mg/l monthly) or topical 3 % TA (2/day). At this stage, the limitations of the currently available data are double: first, most of studies are concerning Asian skin, and secondly there is a lack of a large scale comparative study encompassing these three different ways of administration, which could confirm (or not) our analysis of currently published data.
Authors and Affiliations
C. Diehl
Keywords
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- EP ID EP672779
- DOI 10.30978/UJDVK2019-3-104
- Views 92
- Downloads 0
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