Overall
- Language
- English
- Conflict of Interest
- In relation to this article, we declare that there is no conflict of interest.
- Publication history
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Received February 11, 2025
Revised November 5, 2025
Accepted December 9, 2025
Available online April 25, 2026
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This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/bync/3.0) which permits
unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Tranexamic Acid for Melasma Treatment: An Updated Systematic Review and Meta-analysis of Randomized Controlled Trials
https://doi.org/10.1007/s11814-025-00624-9
Abstract
In this systematic review and meta-analysis of randomized controlled trials (RCTs), we investigated the effi cacy and safety
of tranexamic acid (TA) in treating melasma. Out of 546 articles initially screened, 63 RCTS met the inclusion criteria.
The effi cacy was evaluated using the meta-analysis’s standardized mean diff erences (SMDs). The analysis showed that
oral TA signifi cantly improved melasma severity in patients receiving long-term treatment, particularly by weeks 8 and
12. Topical TA also demonstrated benefi cial eff ects, with noticeable improvements in melasma indices starting from week
8. Subgroup analyses further supported the eff ectiveness of TA in reducing MASI index across diff erent treatment modalities.
Although some adverse events were reported, TA was generally well tolerated. This study suggests that TA should be
widely applied in the treatment of melasma because of its signifi cant improvements.
