Oral tranexamic acid in treatment of melasma in Pakistani population: a pilot study

Objective: To evaluate the efficacy and safety of oral tranexamic acid (TA) in the treatment of melasma in our population. Methods: We performed a descriptive cross sectional study of 65 melasma patients (Fitzpatrick skin types III and IV). Both female and male with moderate to severe melasma were given 250 mg oral TA bid for 6 months along with topical sunscreen. Digital photography was performed initially, and at each visit. Follow-up extended for another six months after completion of treatment to see any recurrence or other side effects. Results were assessed clinically and photographically. Results: 65 patients with moderate to severe melasma were enrolled in the study. The average age was 36 years. 41 patients had good, 15 had excellent and 8 patients had fair improvement. None of the patients had serious systemic side effects, only few had oligomenorrhoea, palpitation and gastric upset. Patients’ satisfaction was similarly noted. Conclusions: Oral tranexamic acid is a safe and effective treatment in patients with melasma.