Oral Tranexamic Acid Promising in Treatment and Prevention of Post Inflammatory Hyperpigmentation: Study

Postinflammatory hyperpigmentation is a common cutaneous disorder due to exaggerated inflammation or injury that results in abnormal pigment deposition in the skin. Although it has long been known as a treatment for melasma, oral TXA is increasingly being considered as an effective treatment of PIH. Indeed, PIH has emerged as one of the most common complications following various skin treatments, including laser-based therapies. Thus, the demand for effective prevention and treatment of PIH is high.

The review was aimed to identify the mechanism of oral TXA in the treatment of PIH and further investigation of its role in preventing PIH associated with laser-based or light-based therapy. The rationale behind this was the collection of data from available studies between 2000 and 2023 that could shed insight into the effectiveness and safety profile of TXA in the context of PIH.

To gather comprehensive data, researchers conducted a systematic review of literature published in the databases such as Cochrane Library, PubMed, Embase, and Google Scholar. The review was conducted using articles that may discuss oral tranexamic acid for the treatment or prevention of PIH and included all studies from 2000 up to now.

The results gathered include data from clinical trials and observational studies that provide an overview of the potential therapeutic outcome of the TXA.

• All the reviewed studies show improvement of patients treated with oral TXA in post inflammatory hyperpigmentation; these improvements include a decrease in the areas and the skin tone overall.

• There were decreased incidences of developing new PIH lesions with TXA used in conjunction with laser or light therapies. Prophylactic use of TXA was associated with lower rates of PIH development subsequent to these therapies.

• TXA was in general, well tolerated with fewer adverse reactions. No major side effects were ever reported and the results of the studies reviewed did not show any indication of dangerous side effects, hence presenting proof of the safety of the drug in terms of using it to treat PIH.

Oral tranexamic acid has proven to be safe and effective as a treatment for PIH with marked improvements without significant side effects. Its effectiveness in the prevention of PIH is also seen when combined with laser and light-based treatments for different skin disorders, in which case it would be an exciting tool for dermatology practice. With the significant additional research that will be conducted to confirm its effectiveness, TXA will play a major role in the prevention and treatment of disorders such as hyperpigmentation, particularly in skin of color.

Reference:

Minasyan, M., Hogan, S., & Lal, K. (2024). Oral tranexamic acid for prevention and treatment of postinflammatory hyperpigmentation. Dermatologic Surgery, 10.1097/DSS.0000000000004400. https://doi.org/10.1097/dss.0000000000004400