Tranexamic Acid
Evidence types available
Originally a haemostatic pharmaceutical drug still used in surgery to control bleeding. Reached dermatology after clinicians noticed patients taking it orally for other conditions experienced unexpected skin brightening. Mechanism: inhibits plasmin-driven prostaglandin release, reducing UV-triggered melanogenesis. Oral RCT evidence (250 mg twice daily) for melasma is strong. Topical evidence (2–5%) is more recent but increasingly robust. Unlike hydroquinone, it is exceptionally well-tolerated across all skin tones and does not carry rebound hyperpigmentation risk on discontinuation.
How tranexamic acid works in skin
Blocks plasmin activity
Reduces UV-induced prostaglandin release
Reduces melanin transfer
Shown effective on melasma in clinical trials
Full cited breakdown coming soon. In the meantime the summary above reflects the current research.