What is the best dose and duration for tranexamic acid in melasma treatment?

Doctor's Answers (2)

Oral tranexamic acid is listed as a hemostatic agent and has been approved for the treatment of menorragia in females. It’s off label use in the treatment of Melasma started after some reports from Japan in 1980 stating that it was useful in the management of Melasma.

Nowadays most doctors would agree that a daily dose of 500mg in 2 divided doses for
a duration of 3 months is the recommended regime . Although there are now studies which show safety up to a period of 6 months.

TA in the form of topical applications usually in combination with other agents like niacinamide and Kojic acid have also been used.

It has also been used intradermally as in a mesococktail. TA can be used alone or in combination with the other more conventional treatment modalities for Melasma. Hope this helps.

Dr Chew

Dr Chin Yee Choong

"Dedicated to the ethical practice of Aesthetic Medicine"

Oral tranexamic acid is an off-label use oral medication for the treatment of melasma not responding to topical lightening agents. Its use for melasma treatment has been largely confined to Asia. The usual dose is 250mg (half a 500mg tablet) twice daily for 12 weeks. Higher doses may or may not confer greater lightening benefits.

The safety of the medication beyond 12 weeks of usage has not been determined. A detailed assessment by your doctor will be required before considering the use of oral tranexamic acid to treat recalcitrant melasma. Patients who are taking oral contraceptive pills, who smoke, have hypertension, diabetes, high lipid levels and who have a past history of clotting problem (e.g. deep vein thrombosis) should avoid taking this drug.

Hope this information helps!

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