Effectiveness and safety of combined use of tranexamic acid and Xiyu dressing in chloasma therapy, and its effect on recurrence in patients

Purpose: To determine the effectiveness and safety of combined use of tranexamic acid (TA) and Xiyu dressing in chloasma patients. Methods: Ninety female patients with moderate-to-severe melasma who were admitted to the Affiliated Suzhou Hospital of Nanjing Medical University (February 2020 - February 2021), were equally divided into 3 groups: A, B and C. Patients in group A were orally treated with TA, those in group B received oral TA and Xiyu dressing, while those in group C received Xiyu dressing only. Treatment effectiveness, Melasma Area and Severity Index (MASI) score, whole blood viscosity (WBV) and disease recurrence rate were assessed. Results: General patient profile was comparable amongst the 3 groups (p > 0.05). Objective treatment effectiveness was higher in group B than in group A, and higher in group A than in group C (p < 0.05). At weeks 8, 16 and 20, the order of Melasma Area and Severity Index (MASI) scores was: C > A > B, with lower scores in group B than in group A, and lower in group A than in group C (p < 0.05). The whole blood viscosity (WBV) was highest in group B, while group C had the lowest WBV (p < 0.05). No notable differences occurred in disease recurrence rate amongst the 3 groups. Onset time of cure was shorter in group A than in group C, but was longer in group A than in group B (p < 0.05). Conclusion: Treatment with TA and Xiyu dressing is more effective when combined than when using either of them alone; furthermore, disease recurrence rate is lowest with the combination therapy. Therefore, the combined therapy has potentials for use in the management of chloasma, but further clinical trials are required prior to application in clinical practice