California Dermatology Care, San Ramon, California, USA.
J Cosmet Dermatol. 2022 Nov;21(11):6393-6399. doi: 10.1111/jocd.15305. Epub 2022 Sep 4.
Melasma is an acquired melanogenesis dysfunction resulting in chronic hyperpigmentation commonly affecting the face and other frequently sun-exposed areas of the body. Melasma typically presents in women of reproductive age and can significantly impact self-esteem, negatively affecting one's quality of life. In the United States, melasma is often treated with application of topical agents that interfere with melanin synthesis, lasers, or chemical peels; however, in some East Asian countries, oral tranexamic acid (TXA) is widely administered to alleviate hyperpigmentation during and after childbirth. TXA is currently only FDA-approved to treat hypermenorrhea and reduce blood loss in surgery but may offer women in the United States an additional therapeutic option to treat melasma.
The aim of this paper is to evaluate the safety and baseline efficacy of oral transmexic acid as a treatment for melasma.
We retrospectively surveyed 42 patients of Fitzpatrick skin types III-VI that were prescribed 650 mg of TXA ½ tablet to be taken twice daily by mouth.
We found majority of patients saw noticeable improvement in their melasma. Of the 42 patients, only seven experienced side effects. The side effects noted were headaches, malaise and nausea, gastrointestinal upset, congestion, numbness in legs, hypomenorrhea, and hypermenorrhea. Patients who experienced unpleasant side effects discontinued taking oral TXA and were relieved of their symptoms. No long-term side effects were discovered, and the side effects experienced may be due to other confounding factors.
From this data, we concluded oral TXA is a safe and effective treatment option for patients with persistent melasma.
黄褐斑是一种获得性黑色素生成功能障碍，导致慢性色素沉着，常见于面部和身体其他经常暴露在阳光下的部位。黄褐斑通常发生在生育年龄的女性中，会显著影响自尊心，对生活质量产生负面影响。在美国，通常使用局部药物、激光或化学换肤来治疗黄褐斑；然而，在一些东亚国家，口服氨甲环酸（TXA）被广泛用于缓解分娩期间和之后的色素沉着。TXA 目前仅获得 FDA 批准用于治疗月经过多和减少手术中的失血，但可能为美国的女性提供另一种治疗黄褐斑的治疗选择。
本文旨在评估口服氨甲环酸治疗黄褐斑的安全性和基线疗效。
我们回顾性调查了 42 名 Fitzpatrick 皮肤类型为 III-VI 的患者，他们被开了 650mg 的 TXA 半片，每日两次口服。
我们发现大多数患者的黄褐斑有明显改善。在 42 名患者中，只有 7 名出现副作用。注意到的副作用是头痛、不适和恶心、胃肠道不适、鼻塞、腿部麻木、月经过少和月经过多。出现不愉快副作用的患者停止服用口服 TXA，症状得到缓解。未发现长期副作用，并且所经历的副作用可能是由于其他混杂因素引起的。
根据这些数据，我们得出结论，口服 TXA 是治疗持续性黄褐斑患者的安全有效治疗选择。
