Efficacy of oral tranexemic acid in refractory melasma: A clinico-immuno-histopathological study.

Tranexamic acid (TXA), a plasmin inhibitor, is an antifibrinolytic drug widely used to prevent and treat hemorrhage. We evaluated the effects of oral TXA clinically and immunohistopathologically in patients of refractory melasma. To evaluate the efficacy of oral TXA in patients with refractory melasma and correlate histopathological and immunohistochemical changes in pretreatment and post-treatment skin biopsies in patients willing to undergo biopsy.

Evidence-based Review, Grade of Recommendation, and Suggested Treatment Recommendations for Melasma.

Treatment of melasma is known to be less satisfactory, often incomplete, and relapse is frequent. Although many treatment options are available, they are either known to be unsafe on long-term use or their long-term safety profile is unknown. Patients often use various drugs, even topical steroid-based preparation without any medical supervision for long period of time, making the skin unsuitable for many of the drugs available.