Tranexamic acid has for many years been shown in studies to be an effective treatment for melasma. This drug still seems to be more well-known for its use in hospitals and dentistry for controlling blood loss. However when applied to the skin it is also capable of significantly altering the biological process that leads to melasma.

How Does Tranexamic Acid Help Melasma?

Tranexamic acid inhibits plasminogen activation to help reduce UV-induced melasma flare-ups. It does this by blocking lysine-binding sites on the plasminogen molecule. What this means is that tranexamic acid interrupts the chemical process that starts when the skin is exposed to UV radiation and leads to a flare-up of melasma. Exposure to UV radiation from the sun is the main trigger for melasma, which is why sun protection is essential even when using tranexamic acid cream.

Topical vs. Systemic Administration

Tranexamic acid has been shown to be effective when used both topically and orally. However there may be a decreased risk of side effects when it is applied topically. In rare cases, oral administration of tranexamic acid can lead to serious adverse reactions that do not exist when the drug is applied on the skin. The topical cream has few side effects and has been demonstrated to be effective, which makes oral administration unnecessary for most patients. Park Compounding Pharmacy does not compound orally administered tranexamic acid.

Tranexamic Acid vs. Other Treatments

There may be less significant side effects from tranexamic acid cream compared to hydroquinone. Hydroquinone is frequently prescribed for hyperpigmentation and is highly effective at altering skin pigmentation. However there is more inflammation associated with hydroquinone use than there is with tranexamic acid. Most in-office melasma treatments can actually complement tranexamic acid cream. This cream has been used in conjunction with laser treatment, IPL, microneedling, and more.

We also make tranexamic acid in a combination cream that contains kojic acid and niacinamide. Kojic acid is a lightening agent that can improve discolorations in the skin, including melasma. Niacinamide inhibits melanosome transfer and has been proven to be effective when applied topically. Other strengths and ingredients are available. Our compounding pharmacy can customize melasma cream formulations to fit each individual’s unique needs.

Research

Effect of tranexamic acid on melasma: a clinical trial with histological evaluation. – Journal of the European Academy of Dermatology and Venereology (PubMed)

Topical tranexamic acid as a promising treatment for melasma. – Journal of Research in Medical Sciences (PubMed)

Tranexamic acid for melasma. – Dermatology Times