Objective.Melasma is a highly prevalent, chronic, and pigmentary disorder.This systematic review aims to evaluate the efficacy and\nsafety of tranexamic acid (TA) for the treatment of adults with melasma. Methods. We independently searched 3 databases from\nbeginning to 26 April, 2018. The study included 21 eligible trials. Two writers extracted data at the same time independently. Study\noutcomes were calculated by standardized mean differences (SMD) with 95% confidence intervals (CIs). All statistical analyses\nwere performed using Review Manager Version 5.3 and STATA Version 15.1. Results.The combined results showed that the use of\nTA was associated with reduced Melasma Area and Severity Index (MASI) and Melanin Index (MI). No significant difference in\nErythema Index (EI) was observed with TA treatment. Side effects were minor, with a few cases reporting mild gastrointestinal\nreaction, oligomenorrhoea, hypopigmentation, urticarial rash, and skin irritation xerosis. Conclusion.Themeta-analysis suggested\nthat TA treatment appeared to be a promising therapeutic approach for melasma.
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