Bala Harini R, Lee Senhong, Wong Celestine, Pandya Amit G, Rodrigues Michelle
Skin and Cancer Foundation Inc., Melbourne, Australia.
Department of Medicine, Monash Health, Melbourne, Australia.
Dermatol Surg. 2018 Jun;44(6):814-825. doi: 10.1097/DSS.0000000000001518.
Melasma is a common acquired disorder of hyperpigmentation that commonly affects those with skin of color. Tranexamic acid (TXA) is a novel treatment for melasma that has a multimodal mechanism of action.
To provide a comprehensive review of the literature regarding the evidence on the mode of action, safety profile, and efficacy of TXA in the treatment of melasma.
The literature was searched for publications on TXA in the treatment of melasma using MEDLINE, Scopus, and Google Scholar.
Oral TXA has clearly demonstrated the efficacy for melasma in Asian skin, even in low doses (e.g., 500 mg daily) over short periods (8-12 weeks). It is also a safe therapeutic option, which is easy to administer with few and mild side effects. Studies have shown that TXA does not increase the thromboembolic risk, although patients should be screened carefully for contraindications and risk factors prior to commencement of the therapy.
Oral TXA is a safe and efficacious treatment for refractory melasma. It should be considered in cases that are unresponsive to topical hydroquinone and combination topical therapy over a period of approximately 12 weeks and without contraindications to oral TXA.
黄褐斑是一种常见的获得性色素沉着紊乱疾病，常影响有色人种。氨甲环酸（TXA）是一种治疗黄褐斑的新型药物，具有多模式作用机制。
全面综述有关氨甲环酸治疗黄褐斑的作用方式、安全性和疗效的文献证据。
使用MEDLINE、Scopus和谷歌学术搜索有关氨甲环酸治疗黄褐斑的文献。
口服氨甲环酸已明确显示对亚洲人皮肤的黄褐斑有效，即使在短时间（8 - 12周）内使用低剂量（如每日500毫克）。它也是一种安全的治疗选择，易于给药，副作用少且轻微。研究表明，氨甲环酸不会增加血栓栓塞风险，尽管在开始治疗前应对患者进行仔细的禁忌症和风险因素筛查。
口服氨甲环酸是治疗难治性黄褐斑的一种安全有效的方法。对于在大约12周内对局部使用氢醌和联合局部治疗无反应且无口服氨甲环酸禁忌症的病例，应考虑使用该药物。
