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2019, Number 2

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Rev Cent Dermatol Pascua 2019; 28 (2)

Oral and topical tranexamic acid in the treatment of melasma. Systematic review

Jurado Santa-Cruz F, Ortiz-Lobato L, Morales SMA, Peralta PML

Language: Spanish
References: 44
Page: 53-64
PDF size: 336.77 Kb.


ABSTRACT

Background: Melasma is an acquired facial dyschromia of chronic and recurrent evolution. Tranexamic acid is used in various presentations as a promising option for the treatment of melasma. There are numerous publications, but few of them are RCTs. The aim of this study is to assess the methodological quality and risk of bias in RCTs with oral, topical and intradermal tranexamic acid as monotherapy and secondarily their efficacy and safety. Methodology: PubMed, Ovid and SciELO were searched for RCTs with tranexamic acid in topical, oral or transdermal monotherapy up to 2018. The Cochrane risk of bias tool was applied for quality assessment by two authors independently. Results: 255 articles were found using the key words «tranexamic acid in melasma treatment», only 14 met the RCT criteria. The risk of bias was higher in the areas of randomisation, blinding and outcome reporting. Conclusions: There is a need for greater methodological rigor in the conduct of clinical trials of melasma with tranexamic acid regardless of the route of administration. The efficacy of oral tranexamic acid as monotherapy is comparable to first line treatment (hydroquinone alone or in combination), unlike topical and intradermal administration where we observe variability in results. It is necessary to use objective evaluations to evaluate the severity of melasma to reduce the risk of bias caused by blinding of the study (patient, staff and evaluator).


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