Can tranexamic acid worsen melasma?

Author: Gabriella Emard  |  Last update: Sunday, June 8, 2025

One clinical study found 0.4% (2 patients) of the studied melasma patients whose hyperpigmentation worsened while taking oral tranexamic acid. Further investigation by researchers showed that sun exposure contributed to worsening of melasma in those patients.

Does tranexamic acid make melasma worse?

No. Tranexamic acid is a pigment disruptor. It helps prevent the chemical pathway that leads to hyperpigmentation and melasma in the skin, which translates to brighter, more even toned skin over time. Unlike hydroquinone there is no concern with paradoxical pigmentation.

Does tranexamic acid cause rebound hyperpigmentation?

Tranexamic acid treats hyperpigmentation through a multifocal approach. At its core, it works by disrupting the pathways that lead to excess melanin production, the pigment responsible for skin colour. When skin is exposed to triggers like sunlight or hormonal changes, it responds by ramping up melanin production.

How long does it take for tranexamic acid to work on melasma?

Results: Oral TXA has clearly demonstrated the efficacy for melasma in Asian skin, even in low doses (e.g., 500 mg daily) over short periods (8-12 weeks). It is also a safe therapeutic option, which is easy to administer with few and mild side effects.

What aggravates melasma?

"The sun is the major exacerbating factor, whatever the underlying cause." Melasma can be caused or worsened by not only the sun's rays, but also heat and visible light. This means that even sunscreens that protect against skin cancer aren't enough to ward off melasma, says Dr. Kourosh.

20 Days Challenge | Get Rid Of Pigmentation, Melasma Dark Spot Naturally

What medications worsen melasma?

Some medications: The following medications may trigger melasma in some people:
  • Anti-seizure medications.
  • Birth control pills (also known as oral contraceptive pills)
  • Medications that make your skin more sensitive to sunlight (includes retinoids, some antibiotics, and some blood pressure medications)

What cancels out melasma?

The most commonly used treatments for melasma are skin lightening medications that are applied topically. These include medications such as hydroquinone, azelaic acid, kojic acid, niacinamide, cysteamine, rucinol, and tranexamic acid.

What not to mix with tranexamic acid?

Most frequently checked interactions
  • Acetylsalicylic Acid (aspirin)
  • Adderall (amphetamine / dextroamphetamine)
  • Adrenalin (epinephrine)
  • Benadryl (diphenhydramine)
  • Claritin (loratadine)
  • Cymbalta (duloxetine)
  • Fish Oil (omega-3 polyunsaturated fatty acids)
  • Iron Sulfate (ferrous sulfate)

Which is better for melasma tranexamic acid or azelaic acid?

A burning sensation was significantly associated with the groups, while no significant association was found for erythema. This study concludes that combining oral tranexamic acid with a modified Kligman's formula is more effective in treating melasma than combining oral tranexamic acid with azelaic acid 15%.

What is the fastest way to cure melasma?

The combination of hydroquinone, tretinoin and a moderate topical steroid has had the best effect on melasma. Other agents that are being studied to improve melasma include: Absorbic acid (vitamin C).

What are the disadvantages of tranexamic acid on skin?

The most common potential side effects are listed below. Though reported instances are rare, tranexamic acid can cause allergic reactions, such as itching, swelling, hives, or a rash.

What is the new treatment for melasma?

Topical proton pump inhibitors (PPIs), such as omeprazole, may also inhibit melanogenesis, and present a promising treatment for melasma. Omeprazole topically applied onto the skin of UV-irradiated human subjects elicited significant reduction of pigment levels after 3 weeks compared to untreated controls46.

When should I stop taking tranexamic acid?

Some side effects can be serious. If you experience any of these symptoms, stop taking tranexamic acid and call your doctor immediately or get emergency medical treatment:
  1. hives.
  2. rash.
  3. itching.
  4. difficulty breathing or swallowing.
  5. swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs.
  6. hoarseness.

Can melasma get worse before it gets better?

It's important to address melasma from different angles and understand that it may get worse before it gets better. I started to gain control by using physical sunscreens that contained zinc and titanium dioxide as well as keep my face out of the sun with cute hats (insert a link to ject hat).

How did I cured my melasma naturally?

Aloe vera is a fantastic melasma treatment at home, known for its soothing and healing properties. Applying fresh aloe vera gel to affected areas can help reduce pigmentation and improve overall skin health. Leave the gel on for 20-30 minutes before rinsing.

Which is better for hyperpigmentation tranexamic acid or vitamin C?

Tranexamic acid and Vitamin C are both effective ingredients for treating hyperpigmentation. They work in different ways, and are both beneficial. One isn't better than the other for fading dark spots.

What is the gold standard treatment for melasma?

Hydroquinone. HQ is the most frequently prescribed depigmenting agent worldwide and it has remained the gold standard for the treatment of melasma, particularly of the epidermal type.

Does melasma come back after stopping tranexamic acid?

One of the studies, which lacked a placebo group, found that MASI scores improved by 69 percent following oral TA. 16 However, 72 percent of patients experienced a relapse of melasma within two months of stopping the oral TA. This occurred despite the use of combination skin lightening topical products.

Is tranexamic acid safe for melasma?

Melasma is a prevalent and challenging skin condition that affects the face and causes distress in many patients and physicians. Tranexamic acid (TA) has been found to be effective for treating melasma and can be administered through multiple routes.

Which two serums cannot be used together?

Skincare ingredients not to mix
  • Retinoids or retinol and benzoyl peroxide. ...
  • Retinoids or retinol and vitamin C. ...
  • Retinoids or retinol and salicylic acid. ...
  • Retinoid or retinol and AHAs/BHAs. ...
  • Vitamin C and AHAs/BHAs. ...
  • Vitamin C and benzoyl peroxide. ...
  • Niacinamide and AHAs / BHAs. ...
  • Benzoyl peroxide and hydroquinone.

What to avoid when taking tranexamic acid?

You should not use this medication if you are also using combination hormonal contraception because it may increase your chance of having a blood clot, heart attack, or stroke. Your risk is even higher if you are overweight, if you smoke cigarettes, or if you are over 35 years of age.

What flares up melasma?

A board-certified dermatologist is your best option for melasma treatment, so your face appears even-toned and healthy. Sun exposure, hormone changes, and genetics are three of the most common triggers of hyperpigmentation and melasma flare-ups.

What is the 3 cream for melasma?

Tri-Luma (fluocinolone/hydroquinone/tretinoin) - Uses, Side Effects, and More. Overview: Tri-Luma is used to treat a condition called melasma, which is where colored areas appear on the face. Tri-Luma contains three medicines.

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