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Use of Oral Tranexamic Acid for the Prevention and Treatment of Post-Inflammatory Hyperpigmentation
TAKE-HOME MESSAGE
- Tranexamic acid (TXA) inhibits the conversion of plasminogen to plasmin, thereby resulting in anti-inflammatory, anti-melanogenic, and anti-angiogenic effects. This oral medication has been widely studied as an effective treatment for pigmentary disorders, such as melasma, at low doses. This literature review assessed the use of TXA in the management of post-inflammatory hyperpigmentation (PIH). A TXA dose range from 500 to 750 mg daily for 12 weeks represents the optimal dose and duration for PIH treatment. The use of TXA 325 mg twice daily initiated 2 weeks before and continued for 2 weeks after a laser procedure has been proposed to prevent PIH. Before starting a patient on TXA, thromboembolic and cerebrovascular accident risks should be assessed.
- Although there are no guidelines published for the use of TXA in the treatment of pigmentary disorders, such as PIH, this review of the literature since 2000 suggests that treatment with low doses of TXA may be effective, with minimal side effects, in appropriate patients.
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Postinflammatory hyperpigmentation (PIH) is a skin disorder characterized by hyperpigmentation resulting from heightened inflammation and/or damage to the basement membrane, melanocytes, and keratinocytes, leading to abnormal and excessive pigment deposition. Oral tranexamic acid (TXA), originally used as an antifibrinolytic for managing excessive bleeding, has garnered attention for its demonstrated safety and efficacy in treating melasma. There is a growing body of evidence regarding the use of TXA in the treatment of PIH.
OBJECTIVE
To review the mechanism of action of oral TXA in treating PIH and examine the use of oral TXA in preventing and/or treating PIH associated with laser-based and light-based treatments in individuals with skin color.
METHODS
Review of relevant articles from 2000 to present found in the Cochrane Library, PubMed, Embase, and Google Scholar, regarding the use of oral TXA in the treatment of PIH.
RESULTS
Studies reviewed investigated the efficacy of oral tranexamic acid (TXA) in treating postinflammatory hyperpigmentation (PIH) and use in preventing PIH when used in conjunction with other treatments. All studies demonstrated significant improvement in PIH without significant adverse effects and side effects.
CONCLUSION
Oral tranexamic acid is emerging as a safe and effective treatment in the prevention and treatment of postinflammatory hyperpigmentation.
Additional Info
Oral Tranexamic Acid for Prevention and Treatment of Postinflammatory Hyperpigmentation
Dermatol Surg 2024 Sep 30;[EPub Ahead of Print], M Minasyan, S Hogan, K LalFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.