Effect of oral tranexamic acid on hair melanin in Asian women

Summary: Abstract Body: Tranexamic acid (TXA) is an antifibrinolytic agent widely recognized for its efficacy in treating melasma by modulating melanin synthesis in the skin. However, its potential effects on hair pigmentation, a concern often raised by patients, have not been thoroughly investigated. This study aimed to evaluate the impact of oral TXA on hair melanin content and color, providing evidence-based reassurance for its use in clinical practice. A three-month prospective observational study was conducted involving seven middle-aged East Asian women who received 500 mg of oral TXA daily, excluding menstruation periods. Hair samples were collected from ten scalp regions both before and after the treatment. Melanin content was quantified using liquid chromatography-tandem mass spectrometry, while hair color was assessed with a tristimulus colorimeter, allowing precise evaluation of pigmentation changes. After three months, no statistically significant changes were observed in hair melanin content (234.2 ng/mg post-treatment vs. 228.5 ng/mg pre-treatment, p=0.29) or hair color (L*=16.8 post-treatment vs. L*=17.0 pre-treatment, p=0.59). These results were consistent across all participants, irrespective of individual variability in hair growth or baseline pigmentation levels. This study demonstrates that oral TXA at a dosage of 500 mg/day does not significantly affect hair pigmentation, offering valuable reassurance for patients concerned about potential hair whitening during treatment. The findings underscore TXA's selective action on UV-induced skin pigmentation without disrupting hair follicle melanogenesis. By addressing this specific concern, the study enhances patient confidence and supports informed decision-making in the management of pigmentation disorders. Further research is recommended to confirm these findings in larger, more diverse populations, as well as to explore the underlying mechanisms that preserve hair pigmentation during TXA therapy. Tingwei Zhang¹, Jinglai Li², Xiangjie Qi¹ 1. Zibo Municipal Hospital, Zibo, China. 2. Guollence Pharmaceutical Technology Co., Ltd, Beijing, China. Clinical Research: Interventional Research