How effective is oral tranexamic acid for melasma?

Doctor's Answers 2

Aesthetic

Tranexamic acid is an off-label use (i.e. not an officially approved indication) oral medication for the treatment of melasma not responding to topical lightening agents. Its use for melasma treatment has been largely confined to Asia.

The usual dose is 250mg (half a 500mg tablet) twice daily for 12 weeks. It is effective in up to 80% of patients. Most patients achieve significant lightening of melasma (usually 50-75% lightening) after about 4-6 weeks of usage.

Maintenance topical therapy using various lightening agents and strict sun protection is recommended after the oral tranexamic acid is stopped to sustain the lightening benefits.

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Dr Chin Yee Choong

Aesthetic

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Maintenance topical therapy using various lightening agents and strict sun protection is recommended after the oral tranexamic acid is stopped to sustain the lightening benefits.

Hope this answer your question!

Similar Questions

Aesthetic Medicine

What is the best melasma treatment in Singapore?

Hi! Melasma is difficult to treat but not impossible to improve. In fact, there are many available treatments to improve melasma. For resistant melasma ( like yours), oral tranexamic acid and low energy thulium lasers are procedures that we will recommend at our practice. Sun protection is so important. Ensure you are using generous amount of sunblock (Broad spectrum, SPF 50) and practise sun avoidance. Some energy devices and IPL will worsen the melasma so always speak to a doctor who is experienced in treating this condition. Btw, you should definitely not use hydroquinone beyond 6 months.

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Aesthetic

Does melasma run in the family?

A genetic predisposition is one of the most important risk factors for the development of melasma (Melasma: A Clinical and Epidemiological Review; An Bras Dermatol. 2014). However, no definite clear pattern of inheritance has been identified so far. Most studies in various populations around the world in patients with melasma cite a positive family history and at least one relative with melasma, as high as 97% of first-degree relatives. However, there are other factors at play too, such as female gender, as you rightly pointed out, hormonal influence, pregnancy, and skin type/colour.

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