Twice-daily application of a topical cream containing tranexamic acid may reduce hypervascular melasma and hyperpigmentation in women, study research published in Dermatologic Therapy suggests.

The study enrolled 60 women between the ages of 25 to 45 years diagnosed with epidermal melasma of the face. Participants had Fitzpatrick skin type 4. Participants were randomly assigned to either a topical cream prescribed for nonhypervascular melasma (n=20), a topical cream that contained tranexamic acid (n=20), or a control cream that contained petrolatum (n=20). The ingredients in the first 2 creams included water, paraffinum liquidum, Sesamum indicum seed oil, glycerin, resorcinol, cetearyl alcohol, sodium cetearyl sulfate, vitamin E, PEG-8, ascorbyl palmitate, ascorbic acid, citric acid, phenoxyethanol, and ethylhexylglycerin.

The investigators instructed participants to apply the cream twice per day for 10 weeks. Melasma severity was evaluated with the Melasma Areas and Severity Index (MASI) score, whereas vascularity assessment was performed with dermoscopy. Safety and efficacy endpoints were assessed every 4 weeks and after 10 weeks of application. All participants were asked to wear an SPF ≥50 sunscreen during the entire study period.

Significant improvements in the MASI score were observed after 10 weeks in participants who applied the nonhypervascular melasma cream and the cream that contained tranexamic acid (P <.05). Use of the cream that contained tranexamic acid was associated with significantly better results compared with the cream without this active ingredient (P <.05). Participants who received the control cream reported that they were unsatisfied with treatment at 10 weeks, whereas participants who applied the other 2 creams reported improved satisfaction during the 10-week treatment period.


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Limitations of the study included the small sample size in each treatment arm as well as the relatively short treatment period and lack of long-term follow-up.

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The investigators concluded that future studies that look “at the molecular mechanism will bring relevant indications for the correct and wide use of” these topical creams.

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Reference

Fioranelli M, Jafferany M, Wollina U, et al. New local treatments for different types of melasma: vascular type vs nonvascular type. A randomized polycentric study [published online March 11, 2020]. Dermatol Ther. doi: 10.1111/dth.13300