Tranexamic acid (or imported torsemide) has been used to treat melasma for more than 30 years and was first published to the medical community by a Japanese doctor in 1979. He was treating adult women with medical conditions and accidentally noticed that some patients with melasma had reduced their discoloration, so he did a large number of case studies and found that this was no accident. With more and more research, it is now believed that it is also related to its original role – to prevent more than one bleeding, by inhibiting the stimulation of some cytokines on melanocytes to achieve the improvement of melasma. I. Are there any side effects of tranexamic acid when taken orally for a long time? The mechanism of tranexamic acid to stop bleeding is not to promote coagulation, but to inhibit fibrinolysis, so the parameters of coagulation function are not affected. It is a mature study abroad, and some experts in China have also conducted a one-year follow-up observation on patients taking tranexamic acid orally and came to the same conclusion. In addition, the dosage of the drug when used to stop bleeding (two capsules three times a day) is much higher than the dosage used to treat melasma (one capsule twice a day in the beginning phase). However, all drugs have side effects, and the most common side effects of tranexamic acid: one is gastrointestinal reactions, including nausea and regurgitation, diarrhea, abdominal pain, etc. (the incidence is 1~5.4%, which is much less than the incidence of 3~9% for another commonly used drug that also needs to be taken for a long time, aspirin.) If this happens, you can choose to take it half an hour after a meal; the other is that about 8.1% of people experience temporary Menstrual flow reduction, then stop taking it during menstruation, most people can recover on their own. Who is not suitable for treatment with tranexamic acid? Patients with a history of blood clots (cerebral thrombosis, myocardial infarction, thrombophlebitis, etc.), patients with consumptive coagulation disorders (with heparin, etc.), and some types of melasma are not effective with tranexamic acid. Can it be used in pregnant or lactating patients? A small amount of data on the use of tranexamic acid during pregnancy showed no harm to the fetus, but we do not feel it is necessary to take this risk, so use with caution in pregnant women. However, because the concentration of tranexamic acid in breast milk is very low (only one percent of the blood) and the infant absorbs very little of the drug from breast milk daily, tranexamic acid can be used by nursing women. How long do I need to use tranexamic acid? This question varies greatly for different people, but generally speaking at least three months, and it is not recommended to stop the medication immediately after it is effective, otherwise there will be a greater chance of recurrence, and the specific method of taking it will be decided by your doctor according to your improvement. Of course, not every melasma patient needs to be treated with tranexamic acid, and tranexamic acid can only solve part of the problem. At present, the best solution for melasma treatment is still personalized and multiple methods combined treatment, so as to get more improvement and faster improvement.