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<p>In this systematic review and meta-analysis of randomized controlled trials (RCTs), we investigated the efficacy and safety of tranexamic acid (TA) in treating melasma. Out of 546 articles initially screened, 63 RCTS met the inclusion criteria. The efficacy was evaluated using the meta-analysis’s standardized mean differences (SMDs). The analysis showed that oral TA significantly improved melasma severity in patients receiving long-term treatment, particularly by weeks 8 and 12. Topical TA also demonstrated beneficial effects, with noticeable improvements in melasma indices starting from week 8. Subgroup analyses further supported the effectiveness of TA in reducing MASI index across different 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 significant improvements.</p>

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Tranexamic Acid for Melasma Treatment: An Updated Systematic Review and Meta-analysis of Randomized Controlled Trials

  • 期刊论文

  • 发表日期：

    2026年1月29日

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  • Le Thi Nhu Ngoc,
  • Ju-Young Moon,
  • Young-Chul Lee

摘要

In this systematic review and meta-analysis of randomized controlled trials (RCTs), we investigated the efficacy and safety of tranexamic acid (TA) in treating melasma. Out of 546 articles initially screened, 63 RCTS met the inclusion criteria. The efficacy was evaluated using the meta-analysis’s standardized mean differences (SMDs). The analysis showed that oral TA significantly improved melasma severity in patients receiving long-term treatment, particularly by weeks 8 and 12. Topical TA also demonstrated beneficial effects, with noticeable improvements in melasma indices starting from week 8. Subgroup analyses further supported the effectiveness of TA in reducing MASI index across different 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 significant improvements.