The results of tranexamic acid on melasma.

Melasma, also referred to as the mask of pregnancy or chloasma, is a form of hyperpigmentation frequently observed in pregnant women, typically appearing as large brown areas on the face, particularly on the cheeks, the bridge of the nose, the forehead and the upper lip. Other parts of the body such as the stomach and forearms can also be affected. This is the result of an excessive and localised production of melanin. There are three types of melasma :

• The epidermal melasma which is the most superficial form with hyperpigmentation of the epidermis;

• The dermal melasma that affects the dermis;

• The mixed melasma which is characterised by both an epidermal melasma and a dermal melasma.

The primary causes of melasma are hormonal changes during pregnancy, following the use of a contraceptive pill, hormone replacement therapy, as well as the use of certain anti-epileptic drugs or even endocrine disorders (for example, thyroid disorder). Repeated solar exposures can exacerbate melasma.

When ingested, tranexamic acid has shown excellent results on melasma. Indeed, researchers have demonstrated a total improvement rate of 80.9% in 256 patients suffering from melasma through long-term oral administration (6 to 15 months) of tranexamic acid. There were no obvious side effects from the treatment, except for a gastrointestinal reaction in 4.3% of patients and hypomenorrhea in 3.5% of patients. Furthermore, another study conducted over eight weeks demonstrated the effectiveness of taking two tablets of tranexamic acid three times a day in conjunction with the topical application of the same active ingredient twice a day on dermal melasma.

For topical application only, thetranexamic acid acts on epidermal type melasmas. Thus, according to a study conducted in 2019, a 5% topical solution of tranexamic acid is as effective as a cream containing 3% hydroquinone. Thetranexamic acid is now presented as a new safe alternative to hydroquinone. As a reminder, this molecule is a bleaching agent banned in cosmetics since 2001 in Europe due to its carcinogenic potential.

Ourhyperpigmentation and firmness serum contains 5% of tranexamic acid. This treatment reduces and prevents the appearance of pigmentation spots, particularly melasma, and promotes skin firming.The complexion is even, the skin is smoother and firmer. It also containsacetyl tetrapeptide-2, a peptide composed of four amino acids that stimulate the synthesis of key molecules involved in skin support and firmness: elastin, collagen and fibrillin.

• NAEINI F. F. & al. Topical tranexamic acid as a promising treatment for melasma. Journal of Research in Medical Sciences (2014).

• JANNEY M. S. & al. A randomized controlled study comparing the efficacy of topical 5% tranexamic acid solution versus 3% hydroquinone cream in melasma. Journal of Cutaneous and Aesthetic Surgery (2019).

• WANG J. V. & al. Tranexamic acid for melasma: Evaluating the various formulations. Journal of Clinical and Aesthetic Dermatology (2019).