Discover the benefits of tranexamic acid for melasma relief, its usage, and what patients should know about it.
Tranexamic acid is a promising treatment for melasma, helping to lighten skin discoloration and even skin tone. This medication works by reducing melanin production, which is the pigment responsible for dark patches.
Melasma causes distress due to its persistent brown spots, impacting confidence and self-esteem. Effective treatments like tranexamic acid can offer hope and improvement for those struggling with this condition.
Researchers have found that a dose of 250 mg, taken twice daily, significantly improves melasma with manageable side effects (Bhattacharjee et al., 2023). While higher doses have been studied, they do not offer additional benefits or safety improvements over the standard dose (Zhu et al., 2019).
Tranexamic acid helps lighten melasma by blocking pathways that lead to excess melanin production, especially when exposed to sunlight (Hushcha et al., 2025). This process involves reducing skin inflammation and limiting signals that cause pigment cells to make more melanin (Ebrahim et al., 2020).
By preventing the action of a specific protein that triggers pigment production, tranexamic acid keeps the number of melanocytes in check (Xing et al., 2022). This multifaceted approach explains why it works well in reducing the dark patches seen in melasma patients (Bala et al., 2018).
Patients taking tranexamic acid might notice smoother, more evenly toned skin after starting the medication. This improvement boosts confidence and reduces stress related to skin appearance.
For melasma, the most studied dosage is 250 mg of tranexamic acid taken twice a day, typically for 8–16 weeks (Bhattacharjee et al., 2023). This regimen has shown efficacy, with patients experiencing significant improvements in skin tone and color (Zhu et al., 2019).
While some studies have examined higher doses like 500 mg, these have not shown better results compared to the lower, recommended dose (Chowdhary et al., 2021). Patients often achieve desired outcomes with the standard regimen, without additional risks from higher dosing (Del Rosario et al., 2018).
The treatment is usually stopped after this period, but your healthcare provider might adjust the plan based on your progress. Consistent follow-up is important to monitor effectiveness and any side effects.
Tranexamic acid is generally well-tolerated, but some patients might experience mild side effects like stomach discomfort or changes in menstrual cycles (Bala et al., 2018). However, it is not suitable for those with a history of blood clots, and screening is advised to minimize risks (Lee et al., 2016).
Knowing these potential issues can help patients have informed discussions with their doctors and make safer choices about their treatments. Always report any severe or unexpected reactions to your physician promptly.
With proper guidance, many individuals find that the benefits of treatment outweigh these mild side effects. Consultation with your healthcare provider is crucial in deciding if this treatment fits your needs.
Many patients worry about relapse after completing treatment, as melasma should be continuously monitored (Minni et al., 2020). Relapse can happen, but consistent skin care and sun protection are vital in keeping results lasting longer (Zhu et al., 2019).
There isn't a universal agreement on maintaining therapy after the initial regimen (Sharma et al., 2017). Your doctor might suggest individual strategies to manage melasma long term, based on your skin's response and care goals.
Understanding these aspects offers valuable insights into your journey with melasma treatment. Staying proactive about preventive measures can help maintain your skin's improved appearance.
While short-term use of tranexamic acid is well-documented, the implications of long-term use lack comprehensive evidence (Chowdhary et al., 2021). Despite this, some patients continue using low-dose regimens under medical supervision for maintenance (Zhu et al., 2019).
Your physician’s advice will be crucial in considering whether to pursue ongoing treatment past the typical duration. Make sure to involve an expert in deciding the best course for your specific circumstances.
Staying informed on the potential risks and benefits aligns you better with your treatment journey. Partnering with your healthcare provider will maximize both safety and effectiveness of your care.
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1. Bhattacharjee R, Hanumanthu V, Thakur V, et al. A Randomized, Open-Label Study to Compare Two Different Dosing Regimens of Oral Tranexamic Acid in Treatment of Moderate to Severe Facial Melasma. Archives of Dermatological Research. 2023;315(6):1831-1836. doi:10.1007/s00403-023-02549-x.
2. Zhu CY, Li Y, Sun QN, Takada A, Kawada A. Analysis of the Effect of Different Doses of Oral Tranexamic Acid on Melasma: A Multicentre Prospective Study. European Journal of Dermatology : EJD. 2019;29(1):55-58. doi:10.1684/ejd.2018.3494.
3. Xing X, Xu Z, Chen L, et al. Tranexamic Acid Inhibits Melanogenesis Partially via Stimulation of TGF-β1 Expression in Human Epidermal Keratinocytes. Experimental Dermatology. 2022;31(4):633-640. doi:10.1111/exd.14509.
4. Hushcha Y, Giuliani AL, Fernanda M, et al. Insight Into the Cellular Activities of Tranexamic Acid as an Option for Melasma Treatment. Cell Biology International. 2025;. doi:10.1002/cbin.70097.
5. Bala HR, Lee S, Wong C, Pandya AG, Rodrigues M. Oral Tranexamic Acid for the Treatment of Melasma: A Review. Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [Et Al.]. 2018;44(6):814-825. doi:10.1097/DSS.0000000000001518.
6. Sharma R, Mahajan VK, Mehta KS, et al. Therapeutic Efficacy and Safety of Oral Tranexamic Acid and That of Tranexamic Acid Local Infiltration With Microinjections in Patients With Melasma: A Comparative Study. Clinical and Experimental Dermatology. 2017;42(7):728-734. doi:10.1111/ced.13164.
7. Minni K, Poojary S. Efficacy and Safety of Oral Tranexamic Acid as an Adjuvant in Indian Patients With Melasma: A Prospective, Interventional, Single-Centre, Triple-Blind, Randomized, Placebo-Control, Parallel Group Study. Journal of the European Academy of Dermatology and Venereology : JEADV. 2020;34(11):2636-2644. doi:10.1111/jdv.16598.
8. Ebrahim HM, Said Abdelshafy A, Khattab F, Gharib K. Tranexamic Acid for Melasma Treatment: A Split-Face Study. Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [Et Al.]. 2020;46(11):e102-e107. doi:10.1097/DSS.0000000000002449.
9. Lee HC, Thng TG, Goh CL. Oral Tranexamic Acid (TA) in the Treatment of Melasma: A Retrospective Analysis. Journal of the American Academy of Dermatology. 2016;75(2):385-92. doi:10.1016/j.jaad.2016.03.001.
10. Del Rosario E, Florez-Pollack S, Zapata L, et al. Randomized, Placebo-Controlled, Double-Blind Study of Oral Tranexamic Acid in the Treatment of Moderate-to-Severe Melasma. Journal of the American Academy of Dermatology. 2018;78(2):363-369. doi:10.1016/j.jaad.2017.09.053.
11. Chowdhary B, Mahajan VK, Mehta KS, et al. Therapeutic Efficacy and Safety of Oral Tranexamic Acid 250 mg Once a Day Versus 500 mg Twice a Day: A Comparative Study. Archives of Dermatological Research. 2021;313(2):109-117. doi:10.1007/s00403-020-02078-x.
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