Research Round-Up — Melasma Treatment and Indoor Tanning Ban

Welcome back for research round-up! Thanks for reading my Monday morning segment on the latest Dermatology research. Today I’ll be discussing an oral adjunctive treatment for melasma and new research regarding the ban on indoor tanning for minors. I’m passionate about skin cancer prevention so I thought today’s topic on indoor tanning was very important to discuss. Keep reading to get the full scoop.

dermatology research roundup featured-image

Oral Tranexamic Acid for Treating Melasma

A study recently published in the Journal of Cosmetic Dermatology found that oral tranexamic acid may help in the treatment of melasma. (1)

Melasma is a chronic hyperpigmentation condition that is hard to treat. It presents are dark spots on the cheeks, forehead, chin, and upper lips. It is most commonly seen in women.

Dermatologists don’t know exactly what causes melasma to develop. However, we know that certain triggers such as hormonal contraceptives and pregnancy can lead to melasma.

melasma example

Standard Treatment of Melasma

Melasma is notoriously difficult to treat and can rebound even after being treated. The standard treatment for melasma is hydroquinone. Hydroquinone is a lightening cream that can stop pigment production in the skin. The current standard of care for melasma is a triple combination cream that includes hydroquinone, a retinoid, and a mild topical steroid.

Oral Tranexamic Acid for Melasma Study Results

In this study of 88 patients, the participants were randomized to receive hydroquinone cream alone or hydroquinone cream plus oral tranexamic acid 250mg three times a day. They measured the severity of melasma at the beginning of the study and 6 months later using the MASI score.


The MASI score (melasma area severity index) is a standard measure of melasma severity used in dermatology research.

The researchers found that for the patients who also received oral tranexamic acid, their MASI score was 1.8 points lower than the patients who only got hydroquinone. However, these findings were not statistically significant between the study groups.

The authors did find a statistically significant difference in treatment satisfaction among the patients who got oral tranexamic acid. This is likely due to a placebo effect.


In this trial the patients were not blinded. This means that only the group who was supposed to get tranexamic acid got pills, and the other group did not get any placebo pills. The differences in treatment satisfaction may be explained by the fact that the treatment group was taking pills that were supposed to help with melasma 3 times a day.

Most Indoor Tanning Establishments Follow the Law

Indoor tanning greatly increases a person’s risk for developing skin cancer. Case in point, indoor tanning before the age of 18 increases a person’s risk of developing melanoma by 85%. Excessive sun exposure is a carcinogen. That’s a known fact. The FDA has been warning the public about the dangers of indoor tanning for minors under age 18 for a while now.

Legislation on Indoor Tanning

However, only 12 states have banned indoor tanning for minors (California, Delaware, Hawaii, Illinois, Louisiana, Minnesota, Nevada, New Hampshire, North Carolina, Oregon, Texas, and Vermont plus the District of Columbia). (2) Some states regulate tanning bed use for minors, but don’t ban it outright.


A study recently published in the Journal of the American Academy of Dermatology sought to evaluate exactly how often indoor tanning establishments are compliant with the law in the state of Texas. (2) The authors had a company of mystery shoppers pose as 17-year-old girls who wanted information on indoor tanning services over the phone.

They contacted 632 indoor tanning providers in Texas. Most of these were dedicated indoor tanning establishments (444). They also contacted 131 salon or spas and 57 business that happened to offer indoor tanning.


The researchers found that 81% of the indoor tanning facilities complied with the ban on indoor tanning for minors. This means they told the 17-year-old girls calling about information that they would not be able to tan with them.

Some Businesses Are More Compliant Than Others

Interestingly, the businesses that were devoted exclusively to indoor tanning had the highest rate of compliance at 86%. Only 68% of salons and spas and 75% of retail businesses that offered tanning were compliant. Obviously, the businesses that specialize in indoor tanning are more knowledgeable on the laws surrounding indoor tanning.

This is important information in the war against indoor tanning. It shows that most facilities are compliant with the law. This means that the laws to restrict minors from accessing these services are working. But, there are still challenges and areas for improvement.

Have you seen any interesting Dermatology research articles lately? Send me a message so I can feature it in the future!


  1. Lajevardi V, Ghayoumi A, Abedini R, et al. Comparison of the therapeutic efficacy and safety of combined oral tranexamic acid and topical hydroquinone 4% treatment vs. topical hydroquinone 4% alone in melasma: a parallel-group, assessor- and analyst-blinded, randomized controlled trial with a short-term follow-up. Journal of Cosmetic Dermatology. October 2016.
  2. National Conference of State Legislatures. Indoor tanning restrictions for minors: A state by state comparison. March 31, 2016.
  3. Tripp MK, Gershenwald JE, Davies MA, Garcia J, Gritz ER, Hawk ET, Peterson SK. Assessment of Compliance With Texas Legislation Banning Indoor UV Tanning by Minors. JAMA Dermatol. Published online November 09, 2016. doi:10.1001/jamadermatol.2016.4068


Leave a comment

Your email address will not be published.