Page 29 - Aesthetics&Dermatology_11_2018

RESEARCH REPORTS

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melasma onset. In addition to
hormonal therapies, genetics and
sun exposure can also be factors.

With that knowledge, researchers
said, dermatologists could augment
melasma treatments by informing
patients about the impacts of these
factors.

In this study, the average participant
age was 40.7 years, and the
average melasma duration prior to
the introduction of oral tranexamic
acid was six years. Patients
received a mean of four months
of oral tranexamic acid therapy
consisting of twice-daily 250
mg doses. On average, patients
participated in seven months of
follow-up.

Overall, the patients tolerated
adjuvant oral tranexamic acid
therapy well, and improvement
occurred, typically, after two
months. Nearly 90 percent–89.7
percent of patients–documented
melasma improvement. Although
oral tranexamic acid was used in
conjunction with both topical and
laser treatments, there were no melasma. 90.6 percent without One patient developed a lower
statistical differences in clinical a family history saw lightening left limb deep vein thrombosis six
outcomes between groups, versus 60 percent of those with weeks after initiating treatment.
researchers said. a family history. Individuals who Researchers determined a family
saw reductions were also older history of protein S deficiency
“This seems to suggest that the at melasma onset, and they had was responsible, highlighting
effects of oral tranexamic acid were experienced melasma for longer the need to screen patients for
independent of the type of topical time periods before oral tranexamic thromboembolism, stroke and heart
therapy used,” they wrote. “And, acid introduction. disease risk factors.
tranexamic acid might be useful as
a monotherapy rather than as an “This suggests that the vascular Ultimately, investigators said, the
adjuvant.” component of melasma, which study shows oral tranexamic acid
oral tranexamic acid is believed to could be promising for melasma
Although most patients experienced modulate, is more likely an acquired patients.
improvement, not all did. An rather than an inherited feature,” the
additional 10 percent remained researchers wrote. “Our results support oral tranexamic
unchanged, and melasma acid as a valuable adjunct treatment
worsened for 0.4 percent (2 Despite the success, however, modality for patients with refractory
patients). Further analysis revealed relapses occurred. After an average melasma,” they wrote. “Treatment
sun exposure played a role in the of 7 months post-oral tranexamic was well tolerate and the majority
melasma cases that progressed, acid treatment, 137 patients (27.2 of patients demonstrated clinical
researchers said. percent) saw melasma recurrence. benefit.”
An additional 7.1 percent
Patients who improved reported a experienced transient side effects,
50-percent lightening. In general, including abdominal bloating and
they had no family history of headaches, investigators said.

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