Tranexamic acid

What does it do?
Reduces melanin (pigment) production in the skin
Reduces inflammation and blood vessel formation

What’s it used for?
Melasma
Postinflammatory hyperpigmentation

How do I use it?
It’s usually a tablet taken twice daily, for a period of 8-12 weeks
Always apply sunscreen during the day

Potential drawbacks
Some patients aren’t suitable for treatment with oral tranexamic acid
A medical assessment is required prior to starting

Evidence rating
Strong

One of the newer players in the ever-growing field of melasma treatments, oral tranexamic acid is one to consider if you aren’t succeeding with traditional treatments. Treatment requires medical supervision, so see your doctor if you’d like to look into it. 

What is tranexamic acid and what is it used for? 

Tranexamic acid is a medication that was originally used for heavy bleeding, but has recently been discovered to be helpful in treating melasma and postinflammatory hyperpigmentation. It’s most commonly used in its oral form, and is usually reserved for cases of severe melasma where topical treatment hasn’t worked. It can be very effective when combined with strict sun protection. It should only be used for limited time periods, under medical supervision. Some patients aren’t suitable for oral tranexamic acid, so a medical assessment prior to commencing treatment is essential. 

I have melasma. Should I be taking tranexamic acid?
Not necessarily. Many cases of melasma can be effectively treated with strict sun protection and a variety of creams. If these are not helpful, tranexamic acid may be considered, but always under close medical supervision and for a limited time. 

What about tranexamic acid in a cream form or an injection?

Topical and injected forms of tranexamic acid have been researched, but there isn’t good evidence to support the use of these forms at present.

References
Bala HR, Lee S, Wong C, Pandya AG, Rodrigues M. Oral Tranexamic Acid for the Treatment of Melasma: A Review. Dermatol Surg. 2018 Jun;44(6):814-825. 

Wang JV, Jhawar N, Saedi N. Tranexamic Acid for Melasma: Evaluating the Various Formulations. J Clin Aesthet Dermatol. 2019;12(8):E73-E74.

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ABOUT THE AUTHOR

Dr-Julia-Rhodes

Spotlight on Skin was created by award-winning Melbourne-based dermatologist, Dr Julia Rhodes.

Julia knows first-hand how overwhelming the skincare world can be, and that’s with over 10 years of experience practicing dermatology. Given that even she gets overwhelmed, she appreciates how hard it can be for those of you without a scientific background to make sense of all the information available, and choose products that are right for your skin…