Expanding Inclusivity: Tranexamic Acid for the Treatment of Melasma in Males

April 2024 | Volume 23 | Issue 4 | e110 | Copyright © April 2024


Published online March 20, 2024

Nicole E. Chin BAa,b, Andrea Hui Austin MDb

aLoyola Stritch School of Medicine, Maywood, IL 
bBay Area Cosmetic Dermatology, San Francisco, CA 
 

melasma. The most commonly reported side effects include menstrual changes, nausea, gastritis, back pain, and headaches.11 In a controlled study of patients with melasma, a dosage of 250 mg of oral TXA given twice daily for 3 months revealed no serious adverse side effects. There were also no statistically significant differences in side effects between the TXA group and placebo group.12 Within our practice, with over 1500 prescriptions (not including refills) of oral tranexamic acid written, we have only seen two cases of venous thrombosis with extenuating circumstances that exacerbated the possible side effects.

Overall, TXA taken orally at 650 mg daily provides patients with a significant reduction of their melasma. Research on this subject heavily focuses on female subjects and a majority of sample sizes make up females in these studies. While melasma predominantly affects women, it is important to acknowledge the impact that it has on men as well. Tranexamic acid has shown to be efficacious in our male melasma patients, and we hope that more men are offered this treatment method to target their melasma. As research continues to explore the applications of tranexamic acid, practitioners should consider the addition of oral TXA into the treatment plans for male melasma patients, as it has shown to be safe and seems effective based on our experience.
 

DISCLOSURES

The authors have no disclosures or conflicts.
 

REFERENCES

1. Callender SLT, Warner GT, Cope E. Treatment of menorrhagia with tranexamic acid. a double-blind trial. Br Med J. 1970;4(5729):214-216. doi:10.1136/bmj.4.5729.214
2. Handel AC, Miot LDB, Miot HA. Melasma: a clinical and epidemiological review. An Bras Dermatol. 2014;89(5):771-782. doi:10.1590/abd1806-4841.20143063
3. Bala HR, Lee S, Wong C, et al. Oral tranexamic acid for the treatment of melasma: a review. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2018;44(6):814-825. doi:10.1097/ DSS.0000000000001518
4. Cho YH, Park JE, Lim DS, et al. Tranexamic acid inhibits melanogenesis by activating the autophagy system in cultured melanoma cells.  J Dermatol Sci. 2017;88(1):96-102. doi:10.1016/j.jdermsci.2017.05.019
5. Jiang J, Akinseye O, Tovar-Garza A, et al. The effect of melasma on self-esteem: A pilot study. Int J Womens Dermatol. 2017;4(1):38-42. doi:10.1016/j.ijwd.2017.11.003
6. Basit H, Godse KV, Al Aboud AM. Melasma. In: StatPearls. StatPearls Publishing; 2023. http://www.ncbi.nlm.nih.gov/books/NBK459271/. Accessed July 10, 2023.
7. Maeda K. Mechanism of action of topical tranexamic acid in the treatment of melasma and sun-induced skin hyperpigmentation. Cosmetics. 2022;9(5):108. doi:10.3390/ cosmetics9050108
8. Okholm SH, Krog J, Hvas AM. Tranexamic acid and its potential anti-inflammatory effect: a systematic review. Semin Thromb Hemost. 2022;48(5):568-595. doi:10.1055/s-0042-1742741
9. Lee HC, Thng TGS, Goh CL. Oral tranexamic acid (TA) in the treatment of melasma: A retrospective analysis. J Am Acad Dermatol. 2016;75(2):385-392. doi:10.1016/j. jaad.2016.03.001
10. Secher JJ, Sidelmann JJ, Ingerslev J, et al. The effect of tranexamic acid and gender on intraoperative bleeding in orthognathic surgery-a randomized controlled trial. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. 2018;76(6):1327-1333. doi:10.1016/j. joms.2017.11.015
11. Colferai MMT, Miquelin GM, Steiner D. Evaluation of oral tranexamic acid in the treatment of melasma. J Cosmet Dermatol. 2019;18(5):1495-1501. doi:10.1111/jocd.12830
12. Del Rosario E, Florez-Pollack S, Zapata L, et al. Randomized, placebo-controlled, double-blind study of oral tranexamic acid in the treatment of moderate-to-severe melasma. J Am Acad Dermatol. 2018;78(2):363-369. doi:10.1016/j.jaad.2017.09.053 

AUTHOR CORRESPONDENCE

Andrea Hui Austin MD hui.andrea@gmail.com
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