Melasma is a common skin condition characterized by hyperpigmentation and vascularization, which can be challenging to treat. Tranexamic acid (TXA) is a promising treatment option for melasma due to its ability to inhibit melanogenesis and angiogenesis. This focused review article provides valuable insights on the drug administration routes for TXA and its effectiveness in treating hyperpigmentation and vascularization associated with melasma.
TXA is a synthetic derivative of the amino acid lysine that has been used for decades to treat bleeding disorders. In recent years, TXA has gained attention as a potential treatment for melasma due to its ability to inhibit plasminogen activator inhibitor-1 (PAI-1), which is involved in melanogenesis and angiogenesis. TXA also has anti-inflammatory properties that can help reduce the severity of melasma.
There are several routes of administration for TXA in melasma treatment, including oral, topical, and intradermal injections. Oral TXA is the most commonly used route of administration and has been shown to be effective in treating melasma in several clinical studies. A randomized, placebo-controlled, double-blind study of oral TXA in the treatment of moderate-to-severe melasma found that oral TXA significantly reduced the severity of melasma compared to placebo. Another study evaluated the efficacy of oral TXA in combination with topical hydroquinone and found that the combination therapy was more effective than hydroquinone alone.
Topical TXA is applied directly to the skin and is typically prescribed in cream or serum form. Topical TXA has been shown to be effective in treating melasma in several clinical studies. Topical TXA can cause skin irritation and dryness. but is generally well-tolerated and has been shown to be better tolerated than topical hydroquinone.
Intradermal injections of TXA are a newer route of administration that has shown promising results in treating melasma. A split-face study of intradermal TXA injections found that the injections were effective in reducing the severity of melasma compared to the control side. Intradermal TXA injections can cause bruising, swelling, and pain at the injection site.
Oral TXA is taken by mouth and is typically prescribed in tablet form. It is the most commonly used route of administration for TXA in the treatment of melasma. Oral TXA has been shown to be effective in treating melasma in several clinical studies. A randomized, placebo-controlled, double-blind study of oral TXA in the treatment of moderate-to-severe melasma found that oral TXA significantly reduced the severity of melasma compared to placebo. However, oral TXA can cause gastrointestinal upset, headache, and dizziness in some patients. In rare cases, it may cause thromboembolic events like deep vein thrombosis, and blood screen may need to be performed before starting treatment. It is important to discuss the potential risks and benefits of oral TXA treatment with your doctor before starting treatment.
TXA is a promising treatment option for melasma due to its ability to inhibit melanogenesis and angiogenesis. There are several routes of administration for TXA in melasma treatment, including oral, topical, and intradermal injections. While TXA is generally well-tolerated, there are some potential side effects to be aware of. Combining TXA with other treatments including vbeam, fractional laser, picosure laser can enhance the effectiveness of treating melasma. It is important to discuss the potential risks and benefits of TXA treatment with your doctor before starting treatment.