Skin Tranexamic Acid Might Be Elective For Long-Term Treatment Of Mild Melasma

Topical tranexamic acid might be an option to hydroquinone for the long-term management of mild to direct melasma, as indicated by a specialist agreement.

“Because of its complex pathogenesis, chronicity and high rates of recurrence, melasma is regarded as a challenging skin disorder,” Seemal R. Desai, MD, of the Department of Dermatology at the University of Texas Southwestern Medical Center, and colleagues wrote.

Although topical treatments are frequently used as first-line therapy, many patients are unaware that melasma can recur. Management for the long term is required.

Melasma relapses can be controlled with hydroquinone. However, its adverse event profile has restricted its application in certain circumstances.

Hence, skin tranexamic acid (TXA) alone or in combination with different treatments might be a more attractive option for specific patient populations, incorporating those with relapsed or refractory melasma or the people who have failed on different medicines.

Dermatologists should keep Desai and colleagues’ suggestions in mind when treating these patients.

In the first place, clinicians ought to grasp the chronicity of melasma, and patients ought to be advised on the significance of sun security.

Second, the severity of the melasma and the erythema of the skin should be assessed prior to beginning treatment. It is likewise critical to decide whether the patient has vascular contribution, for example, clinical as well as dermoscopic telangiectasia, and whether this influences patient personal satisfaction.

Thirdly, patients with less severe disease that has vascular involvement or a telangiectatic pattern may benefit from topical TXA.

Fourth, 75% to 80% improvement is considered therapeutic success. However, patient contentment ought to also be taken into account as a measure of success.

Fifth, a balance between benefit and risk and long-term success should take precedence over short-term success.

Lastly, TXA treatment may be required for a long time.

“Topical TXA can be offered as first-line monotherapy for induction of mild to moderate melasma,” the researchers wrote. “Current experience and data also suggest that topical TXA can be used as a monotherapy for long-term maintenance in melasma.”