Interrupting the Melasma Cycle with Tranexamic Acid

By: Katy Leonard


With Katy Leonard, RN at Bay Area Cosmetic Dermatology

Ready to elevate your melasma and hyperpigmentation treatment tool kit? Welcome tranexamic acid!

You may have heard of this increasingly popular skincare ingredient and wonder if it’s  worth a try.  As a registered nurse at BACD who has melasma and has tried just about everything to treat it, I wanted to share my experience incorporating tranexamic acid (TXA) into my skincare routine.

Let's start with a simplified version of the science behind melasma.

Melasma is a chronic skin condition that causes patchy skin discoloration and uneven pigmentation  primarily on the face. While it is not fully understood, there are a  few known triggers like hormone fluctuations, sun exposure/damage, inflammation, and even heat. These triggers set off a chemical cascade in the skin, which stimulates the pigment producing cells (or melanocytes) to generate excess melanin, causing uneven skin tone.

Melasma can feel like a constant battle as there is no true "cure." Its treatment requires diligence with an appropriate skin care routine, direct sun avoidance, and melasma-safe treatments like chemical peels. The uneven pigmentation can be hard to cover with makeup and can worsen easily if not treated properly. This can be so frustrating! 

Like many of our amazing patients, I currently or have used products that contain arbutin, kojic acid or hydroquinone to help even out my skin, but am always willing to try something new to keep my melasma further under control. So, I was excited to  add the BACD Rx 10% Tranexamic Acid Cream into my daily skin regimen to see how it worked.

How does tranexamic acid help?

Tranexamic acid is a synthetic form of the amino acid lysine, which  interrupts the irregular stimulation of melanocytes and their pigment producing effects. It can be found in serums, creams, or even be taken as an oral medication to help with melasma and hyperpigmentation.

My personal experience with tranexamic acid

What I love about the BACD Rx 10% Tranexamic Acid Rx Cream  is how easy it is to use! I simply added it right into my usual routine. In the morning, after cleansing and using my Obagi-C Rx Serum, I applied one pump of TXA cream. It felt great on my skin, silky and hydrating, so I didn’t need additional moisturizer. 

I then apply my SPF and makeup as usual. At night, I cleanse my skin, swipe my face with one of our BACD Rx Skin Brightening Pads and apply another pump of the TXA cream. 

Two or three times a week I also use our BACD Rx Gentle Tretinoin on top of the TXA cream at night for enhanced anti-aging benefits. 

My results with tranexamic acid

At first, I wasn't quite sure I noticed much improvement from my usual routine with the addition of the tranexamic acid cream, but patience is a virtue! After about 8 weeks, my skin started to look more even and healthy, and  it especially helped me break through the pigment plateau I was having with my usual at-home regimen.

With continued use I noted even further improvement. Check out my photos below, taken 3 months apart. 

Tranexamic Acid Results for th

Suffice it to say, tranexamic acid has passed my test and has now become a permanent part of my routine! 

Additional benefits of tranexamic acid

There are other benefits of tranexamic acid as well. It may be recommended to take breaks from using hydroquinone to avoid any paradoxical pigmentation from its use. With topical tranexamic acid there are no limits and it can help maintain your even skin during these breaks. 

It's also anti-inflammatory and can help with the redness from  rosacea or acne flare ups. Our BACD Tranexamic Acid Cream is a 10% strength, which is well above the minimum recommended amount found in most over the counter products. There are no harsh ingredients so it is generally non-irritating for most people. 

If you prefer lighter serums, or have oily or acne prone skin, the SkinCeuticals Discoloration Defense, which offers 3% tranexamic acid may be a better choice. 

Think you may want to give tranexamic acid a go? Consult with our expert skin team and see how we can work this gem of an ingredient into your routine! Book appointment here. 


Can tranexamic acid cure melasma?

Unfortunately, there is no "cure" for melasma. However, proven treatments like tranexamic acid help reduce its appearance and keep it in remission.

Can tranexamic acid darken skin?

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.

Where can I buy tranexamic acid?

You can purchase products containing tranexamic acid from our webstore or in office. We carry BACD 10% Tranexamic Acid Rx Cream (available to current BACD patients only due to it's prescription level strength), SkinCeuticals Discoloration Defense, (3% Tranexamic Acid), and SkinMedica Lytera 2.0

Some of our customized treatment plans for melasma or post inflammatory hyperpigmentation also include an oral Tranexamic acid which can be very successful for the right candidate. Read more how oral Tranexamic acid is used in the peer-reviewed article in Journal of Drugs in Dermatology. Article co-authored by BACD dermatologists Kathleen M. Welsh, MD and Andrea Hui Austin, MD.  


* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.