Can Tranexemic Acid treat dark spots

Move over, Hydroquinone. Tranexemic acid (or TXA for short) is the new ingredient on the skincare block that promises to lighten discolourations and even out the skin tone – without annoying side effects (like turning your skin blue – yes, hydroquinone CAN do that). Beauty editors and influencers are raving about its superpowers and brands are putting it everywhere.

But, does it work? There are a gazillion skin-lighteners on the market, so why should you turn to this? What its advantage? So many questions… No worries, I’ve got answers. Here’s what science says about Tranexemic acid and whether it has what it takes to fade away YOUR dark spots:

What Is Tranexemic Acid?

Tranexamic acid {TXA) is a synthetic amino acid derived from lysine (an amino acid involved in the biosynthesis of proteins). It’s been traditionally used to reduce excess bleeding during surgery, nosebleeds, and even heavy menstrual periods. It works by slowing down the production of plasmin, an enzyme in your blood that dismantles blood clots.

In 1979, a medical professional noticed dark spots fading in a patient taking Tranexemic acid for urticaria. Coincidence? I don’t think so. After this discovery, dermatologists started prescribing Tranexemic acid for hyperpigmentation, too.

You can get your Tranexemic acid fix in several different ways: as an oral supplement, topically in a cream or serum, or by injecting it into the lower levels of your skin.

Related: Why You Should Add Amino Acids To Your Skincare Routine

Don’t know how to mix and match skincare ingredients? Subcribe to the newsletter below to download the “How To Combine Actives Like A Pro” cheatsheet and find out:

Benefits Of Tranexemic Acid For Skin: What Does It Do?

Tranexemic Acid is a skin-lightener that reduces hyperpigmentation, dark spots, and dullness. How does it work? This is where it gets a bit technical, so bear with me (or skip to the next section to find out more about the benefits of Tranexemic acid for melasma – in plain English).

According to Dr Emma Wedgeworth. “Tranexamic acid slows the production of melanin by inhibiting a pathway known as the plasminogen/plasmin pathway. By doing so, it reduces the interactions between our pigment-producing cells (melanocytes) and skin cells (keratinocytes) and this leads to a reduction in pigmentation, particularly in melasma.”

This is where it gets a bit technical, so bear with me (or skip to the next section to find out more about the benefits of Tranexemic acid for melasma – in plain English):

  • Anti-inflammatory: It reduces the amount of cells that release inflammatory mediators after prolonged UV exposure, so they can’t trigger the excessive production of melanin (the pigment that gives your skin its natural colour).
  • Tyrosinase inhibitor: Tranexemic Acid is very similar to tyrosine, an amino acid that slows down the activity of tyrosinase (the enzyme that controls the production of melanin). Researchers think it works in the same way, too.
  • Melanocyte disruptor: It interferes with the interaction of melnocytes (the cells that produce the pigment that gives your skin its natural colours) and keratinocyte (the most common type of skin cells found in the epidermis).
  • Blood clotter: It reduces blood vessels in the affected area of skin.

In other words, Tranexemic Acid stops the production of excess melanin in its tracks. When that stops, your dark spots, slowly go back to their natural colour. Well, some of them do. Tranexemic Acid doesn’t work on all types of hyperpigmentation…

Related: Battle Of The Skin-Lighteners: Which Is The Best Alternative To Hydroquinone?

Tranexemic Acid For Melasma: An Effective Treatment?

Melasma is a pigmentation disorder that turns patches of skin brown or grey. It can happen everywhere, but it’s more common in the face. What causes it? Genetics, unprotected UV exposure and hormonal changes, especially during pregnancy. It’s such a common condition during this special time, it gained the nickname “the mask of pregnancy”.

You’re more likely to get melasma if you’re from African, Asian, or Hispanic descent. Once you do, it’s very hard to treat. Not many treatments can do the deed. Preliminary research shows that Tranexemic Acid has what it takes to treat melasma,

The catch? Most of these studies were done on Asian patients, so we don’t know how well TXA works on other ethnicities. Still, if you’ve tried chemical peels and lasers without success and you’re not ready for Hydroquinone yet, Tranexemic Acid is definitely worth a try. Talk to your doctor to find out the best delivery option for you.

Related: Is Hydroquinone As Dangerous As They Say?

Does Tranexemic Acid Work For Other Types Of Pigmentation, Too?

You’d think that if Tranexemic Acid works for melasma, it’ll work for all other types of pigmentation, like freckles and age spots, right? Think again:

Sure, there are studies that show Tranexemic Acid can lighten age spots and other types of discolourations… when used together with other skin-lighteners like Alpha Arbutin or Kojic Acid.

Alone, it doesn’t do the deed. And that begs the question: does Tranexemic Acid really contribute to lessening discolourations when used with other skin-lighteners or did Alpha Arbutin & co do all the work?

Bottom line: if you don’t have melasma, don’t bother with Tranexemic Acid. It likely won’t do anything for you.

Related: Kojic Acid VS Hydroquinone: Which One Is Right For You?

Can Tranexemic Acid Reduce Redness?

As Tranexemic Acid has anti-inflammatory properties, it could help reduce redness. Preliminary research is promising, but by no way conclusive:

  • A 2019 study shows that 5% Tranexemic Acid used every night for 6-8 weeks can reduce redness after acne.
  • A 2020 study found that 10% Tranexemic Acid helps relieve redness associated with rosacea.

There’s almost nothing that works for redness (the best thing I’ve found is Niod Modulating Glucosides). If you’re struggling with this, you may want to ask your doctor about using Tranexemic Acid.

Related: My Full Review Of Niod Modulating Glucosides

How Do You Use Tranexemic Acid?

Oral supplements and injections are more effective than OTC topical products. Consult your doctor for the best way to use them. Even then, your dermatologists will probably use Tranexemic acid together with other treatments: “I like combining this with a retinol; I like combining it with a chemical peel; it’s definitely a good adjunct to treating melasma, but it’s not enough on its own,” says dermatologist Kristina Goldenberg.

Wanna wet your feet in the water (or your skin in Tranexemic Acid) before going all in? Topical products are your best bet. Here’s how to use them:

  • Wear sunscreen: Unprotected sun exposure is the main cause of dark spots. If you use any skin-lightener without sunscreen, you risk the discolouration becoming darker, not lighter. To avoid that, apply sunscreen generously in the morning and often during the day.
  • Start small: A slight tingle is normal. Anything more than that and you’re irritating your skin. If this happens, start with a smaller concentration or use it less often. You can always build up dose and frequency gradually as your skin gets used to it.
  • Mix and match: Unless your skin is very sensitive, once you’ve built tolerance to Tranexemic Acid, you can use it together with retinol and Vitamin C to fade away melasma even faster.

Related: Mix And Match: What Skincare Ingredients Shouldn’t You Use Together?

Who Should Use It?

Tranexemic acid is generally considered to be safe for everyone with melasma, so all skin types can use it. If your skin is so sensitive, anything irritates it, it’s a good idea to do a patch test. Simply apply a small drop of Tranexemic acid onto a small patch a skin, like your wrist, and see what happens. If, after a few hours, nothing happens, use Tranexemic acid on your skin. If you’re experiencing redness or irritation, ditch it.

How Often Should You Use It?

That depends. If you want to fade your dark spots away as soon as possible, the ideal frequency is twice a day, once in the morning and once in the evening. Still, some ingredients can be too irritating when used too often. Start with once a day and see how your skin reacts. If all’s well, you can always increase frequency later on.

What Should You Use It With?

For best results, use Tranexemic Acid with other skin-lighteners, like Vitamin C, niacinamide, Kojic Acid, or Glycolic Acid. Just be careful that using too many of these actives all at once can be too much for skin and cause dryness and irritations. Instead, look for a serum that contains multiple skin-lighteners. They’re formulated to provide maximum effectiveness with minimal side effects.

What Should You Not Use It With?

Be careful to use it with other exfoliating acids, like Salicylic Acid and Glycolic Acid. Using too many acids in your skincare routine can be too much for skin and irritate it. The exception? If a product contains both Tranexemic Acid and Glycolic/Salicylic Acid. It’s especially formulated to allow the ingredients to work well together and minimise the risk of irritations.

How Long Does It Take For Tranexemic Acid To Work On Skin?

It can take between six to eight weeks of daily Tranexemic Acid use before you can start seeing results. This is true for all skin-lighteners. It simply takes time for the skin-lightening process to kick-start.

Tranexemic Acid Side Effects

Tranexemic Acid is gentler than Hydroquinone, but it can still cause irritation and dryness in sensitive skin. You can counteract this side effects by using a rich moisturiser. If, despite this, the irritation persist, stop using the product altogether.

Oral TXA can cause digestive issues and potentially increase the risk of blood clots. That’s why you need to take it under doctor’s supervision.

Is Tranexemic Acid Safe During Pregnancy?

I haven’t found any studies showing Tranexemic Acid isn’t safe during pregnancy. However, it’s always better to consult your doctor before taking it, just in case.

How Does Tranexemic Acid Compare To Other Skin-Lighteners?

Tranexemic acid is a wonderful skin-lightener for melasma. Not so much for other types of dark spots. Plus, is it really the best treatment for melasma, or is there something better? Here’s how it compares to other popular skin lighteners:

Tranexemic Acid VS Hydroquinone: Which One Is Better?

Hydroquinone is still the gold standard treatment used by dermatologists to treat melasma and any other type of dark spots. It works by inhibiting the activity of tyrosinase, the enzyme that controls the synthesis of melanin and increasing the cytotoxicity of melanocytes (it kills the cells that produce melanin). The catch? It can be drying and cause a permanent bluish discolouration on darker skin tones.

How does it compare to Tranexemic Acid? A 2017 study compared a 5% Tranexemic acid solution applied twice a day for 12 weeks to a 2% hydroquinone solution with the same frequency. The results? Both treatments significantly reduced melasma, but the Tranexemic acid group experienced no side effects, while 10% of patients who used hydroquinone suffered irritation and erythema. “Regarding the level of patient satisfaction, the patients in group A [Tranexemic acid] had a significantly higher level of satisfaction level of 33.3% compared with 6.7% in group B [Hydroquinone],” researchers noted.

Hydroquinone is also NOT recommended during pregnancy.

The verdict: Tranexemic acid is an effective and gentler alternative to hydroquinone for the treatment of melasma. It’s also a better choice for pregnant women, but consult your doctor before using it.

Tranexemic Acid VS Alpha Arbutin: Which One Is Better?

Derived from bearberry leaves, Alpha Arbutin turns into hydroquinone when applied to the skin. It fades away dark spots by mimicking the enzyme tyrosinase to slow down the production of melanin and interfering with the maturation of melanosomes (the organelles responsible for melanin production).

Arbutin is gentler than hydroquinone, but high concentrations can cause post-inflammatory hyperpigmentation (dark spots left behind by inflammation). It’s also not suitable during pregnancy.

I wasn’t able to find any studies comparing Tranexemic acid with Alpha Arbutin, but I’ll say this. Based on what we know of both ingredients, Tranexemic acid is a gentler alternative for melasma, especially in pregnancy. Alpha Arbutin is more effective at treating other types of dark spots.

The verdict: If you’re pregnant or have sensitive skin, use Tranexmic acid for melasma. If your dark spots are not melasma, Alpha Arbutin is the more effective option.

Tranexemic Acid VS Azelaic Acid: Which One Is Better?

Made by the health bacteria that live on your skin, Azelaic acid is a powerful skin-lightener that inhibiting the synthesis of melanin (the pigment that gives skin its natural colour) to reduce dark spots and discolouration. Plus, it has anti-inflammatory and exfoliating properties that treat acne too and is gentle enough for sensitive skin.

Again, I couldn’t find any studies comparing Tranexemic acid with Azelaic acid. Both acids work well for sensitive skin, so it really depends what you need. Have dark spots and acne? Go with azelaic acid. Have only melasma? Tranexemic acid may be a better fit for you.

The Verdict: Azelaic acid is the better option to treat dark spots and acne at the same time. If you only have melasma, Tranexemic acid will do.

What Are The Best Skincare Products With Tranexemic Acid?

  • Medik8 Press & Clear ($34.00): If you have oily skin and want to treat acne/blackheads and melasma at the same time, try this. It uses 2% Tranexemic acid to fade away melasma and 2% salicylic acid to unclog pores and get rid of acne. Available at Cult Beauty, Medik8, Sephora, and SpaceNK.
  • Paula’s Choice CLINICAL Discoloration Repair Serum ($52.00): This serum uses both niacinamide and Tranexemic Acid to fade away melasma. For other types of dark spots, it doesn’t work as well. Plus, it has natural oils to moisturise dry skin. Available at Cult Beauty, Dermstore, Paula’s Choice, and SpaceNK.
  • Skinceuticals Discolouration Defense Corrective Serum ($108.00): This serum contains three different skin-lighteners (Tranexemic Acid, Kojic Acid, and Niacinamide) to fade away all kinds of dark spots. Available at Dermstore and Skinceuticals.
  • SkinMedica Even And Correct Advanced Brightening Treatment ($178.00): This skin-lightening treatment costs an arm and a leg, but if you can afford it, it’s worth the splurge. It uses Tranexemic Acid, Niacinamide, and Phenylethyl Resorcinol to fade away melasma and hyaluronic acid to hydrate skin and counteract dryness. Available at Dermstore.
  • The Inkey List Tranexemic Acid Overnight Treatment ($14.99): A simple, no-frills 2% Tranexemic Acid serum with a Vitamin C derivative to brighten skin and fade away melasma. Available at Boots, Cult Beauty, Sephora, and The Inkey List.

The Bottom Line

Tranexemic Acid, especially when taken orally, is a promising new treatment for melasma. But there’s no proof it can treat other types of discolourations, yet.