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Treatment of Melasma With Oral Administration of Tranexamic Acid

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Melasma is a common pigmentary disorder among Asian women. The available therapies such as bleaching agents, chemical peeling, laser, and intense pulsed light are not satisfactory or safe. In the search to find a new treatment therapy for melasma, oral administration of tranexamic acid (TA) was studied clinically in Chinese patients.


The study enrolled 74 patients. Tranexamic acid tablets were prescribed at a dosage of 250 mg twice daily for a therapeutic period of 6 months. All the patients were followed up for more than 6 months after the treatment. The effects of treatment were evaluated by two physicians independently and by the patient based on improvement of pigmentation and reduction in melasma size. These were graded into four levels: excellent, good, fair, and poor.


After 6 months of treatment, the effects were graded as follows: excellent (10.8 %, 8/74), good (54 %, 40/74), fair (31.1 %, 23/74), and poor (4.1 %, 3/74). Side effects of TA such as gastrointestinal discomfort (5.4 %) and hypomenorrhea (8.1 %) were observed, but no severe complications were found. The recurrence of melasma was observed in seven cases (9.5 %).


Oral administration of TA is an effective and safe therapy for the treatment of melasma.

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The authors were instructed by Dr. Kenichiro Kasai. The study involved much work in photo-taking and follow-up evaluation of patients, which were well performed by Ms. Qing Wang and Ms. Fei Han. The authors thank all of them for their kindly help and hard work.

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Correspondence to Sufan Wu.

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Wu, S., Shi, H., Wu, H. et al. Treatment of Melasma With Oral Administration of Tranexamic Acid. Aesth Plast Surg 36, 964–970 (2012).

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