Aim: To compare the efficacy and safety of oral tranexamic acid with topical kojic acid in treatment of melasma.

Method: This study was an interventional, randomized control trial done in Department of Dermatology Akhtar Saeed Trust Hospital Lahore from January 2020 till June 2020. 40 patients with moderate to severe melasma were enrolled for this study. These were divided into two groups A and B. In group A 20 patients were given oral tranexamic acid along with topical treatment and in group B, 20 patients were treated only with topical treatment. Oral tranexamic acid was given in dosage of 250 mg twice a day for 3 months and then follow-up was done at 8th and 12th wks. The evaluation of effectiveness of treatment was done with MASI(Melasma Area Severity Index). Comparison was done in the mean of the MASI scores obtained in both groups.

Result: In both groups female patients were more in number. The mean age of patients in group A was 29.75 years & in group B it was 32.55 years. MASI scoring was done in both groups at baseline and at 8th& 12th wks. There was a significant decrease in this score in group A patients with oral tranexamic acid (12.08±2.8 vs 9.1±2.2 at 8th wk. andvs 8.2±2.0 at 12thwk.; P <0.05for both). Whereas in group B patients the decrease in mean MASI score was significant at 8thwk.& insignificant at 12th wk. (12.6±2.9 vs 10.9±2.4at 8th wk. and vs 10.3±2.4at 12th wk.; p<0.05 for former but p>0.05 for later).

Conclusion: Oral tranexamic acid is a safe and effective treatment modality for treating moderate to severe melasma.

Keywords: Melasma, oral tranexamic acid