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Oral Tranexemic Acid in the treatment of Melasma (Chloasma) (Pregnancy Mask): An Introduction

  • Melasma (Chloasma) (Pregnancy Mask) is a frequent cause of acquired hyperpigmentation, particularly in Asian women.
  • Although associated with sun exposure, pregnancy, oral contraceptives and hormones replacement therapy, the physiopathology of its development remains largely unknown.
  • Locally applied agents (topicals) are the mainstay of treatment, but their efficacy is highly variable.

 

 

  • In patients who do not respond to topical therapy, IPL (Intense-Pulse Light) and pigment laser have been tried.
  • However, their efficacy is limited and non negligible side effects can happen. These include “rebound” hyperpigmentation and mottles hyperpigmentation.
  • Tranexemic acid (also called trans-4-aminomethylcyclohexanecarboxylic) is an antifibrinolytic agent (derived from lysine) which inhibits the activation of plasminogen, through reversible blockade of sites linking to lysine located on the plasminogen molecule). It has been shown in vitro that tranexamic acid inhibits the synthesis of melanin by interfering with the interaction between melanocytes and keratinocytes (by inhibiting the plasmin/plasminogen cascade).

 

 

Bibliography: Goh BK. Oral Tranexamic Acid in the treatment of Melasma Refractory to Topical Therapy.Ancillary Meeting on Pigment Cell Research. World Congress of Dermatology (WCD). Seoul, South Korea

Source of information: here