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Updated: Jul 27, 2025

Author Spotlight: Non-Surgical Treatment of Melasma– Microneedling with Tranexamic Acid
Published on: January 19, 2024
Oral Tranexamic Acid for the Treatment of Melasma: Evidence and Experience-Based Consensus Statement from Indian
Kiran Godse1, Rashmi Sarkar2, Venkataram Mysore3
1From the Department of Dermatology, Dr. DY Patil Medical College, Navi Mumbai, Maharashtra, India.
Abstract:
Melasma, a chronic pigmentary skin condition mainly affecting the face, remains a challenge despite the availability of several options for treatment. Many melasma patients are not satisfied with treatment outcomes. Tranexamic acid (TXA), an anti-fibrinolytic drug has shown promising results in patients with melasma. Evidence from several clinical studies has surfaced on efficacy and tolerability of TXA in these patients. It can be used as monotherapy or adjuvant with other therapies. Currently, there is no published consensus or guideline document for its use in the treatment of melasma. TXA is available for oral use, topical use as well as an injection. In this article, a consensus of Indian experts is prepared based on the available literature and experience with use of oral TXA in melasma. This review article might help clinicians for use of oral TXA appropriately while treating melasma.
Insights
Oral tranexamic acid (TXA) offers a promising treatment for melasma, a difficult skin condition. This expert consensus provides guidance on using oral TXA effectively for melasma patients seeking better outcomes.
Area of Science:
- Dermatology
- Pharmacology
Background:
- Melasma is a persistent facial hyperpigmentation disorder with limited treatment satisfaction.
- Tranexamic acid (TXA), an anti-fibrinolytic agent, shows potential for melasma treatment.
Purpose of the Study:
- To establish an expert consensus on the use of oral tranexamic acid (TXA) for melasma treatment.
- To provide clinical guidance based on existing literature and expert experience.
Main Methods:
- A review of current literature on tranexamic acid (TXA) for melasma.
- Consensus development among Indian experts regarding oral TXA application.
Main Results:
- Tranexamic acid (TXA) demonstrates efficacy and tolerability in melasma patients.
- Oral TXA can be used as monotherapy or adjunctively with other treatments.
Conclusions:
- There is a need for standardized guidelines for oral tranexamic acid (TXA) in melasma management.
- This consensus aims to aid clinicians in the appropriate use of oral TXA for melasma.
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