Role of oral tranexamic acid in melasma patients treated with IPL and low fluence QS Nd:YAG laser

Background: Recently, tranexamic acid (TNA) containing oral medication has gained public attention, claiming for whitening effects. Objective: This study was performed to evaluate the clinical efficacy and safety of oral TNA as an adjuvant to intense pulsed light (IPL) and laser treatment in melasma. Methods: A total of 51 patients were included in the study. Patients who have been on oral TNA during IPL and laser treatments (group A) and those who were treated with only IPL and laser (group B) were analyzed (from winter to summer). Modified melasma area and severity index (mMASI) scores were blindly evaluated by two investigators using digital photographs taken at each visit. Results: The mean modified MASI score decreased from 11.33 +/- 7.07 to 6.21 +/- 5.04 in group A and from 11.70 +/- 6.72 to 8.93 +/- 5.89 in group B (baseline vs. 2 weeks after the last treatment, p = 0.005). Modified MASI score right before and after IPL were more reduced in group A. No serious adverse effects were reported up to 8 months of oral TNA medication. Conclusion: Oral TNA may improve clinical efficacy in light-or laser-based melasma treatment especially during the period of relative high sun exposure without serious adverse effects.