What the science says about Tranexamic Acid

Peer-reviewed research on Tranexamic Acid, summarised in plain language. Every study links to its record on PubMed so you can read it yourself.

Tranexamic Acid for hyperpigmentation

Some evidence for hyperpigmentation

Most studies found tranexamic acid helped fade melasma and other dark patches
Used on its own, it reduced how dark and widespread melasma patches were
Used with laser treatment, it often faded melasma more than laser alone
Different ways of using tranexamic acid often worked similarly, though some reviews found oral use or microneedling worked better
The most common side effects were stomach upset, skin irritation, and menstrual changes

19 studies

Efficacy and safety of microneedling with tranexamic acid versus microneedling with vitamin C in the treatment of melasma: a systematic review and meta-analysis.
Journal of medicine and life2026Meta-analysis232 participantsNeutral
In a review of 232 people, microneedling with tranexamic acid worked about as well as microneedling with vitamin C for melasma.
PubMed 42602406 DOI
Intradermal Injection of Tranexamic Acid for the Treatment of Adult Melasma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Facial plastic surgery & aesthetic medicine2025Meta-analysisPositive
A large review found that injected tranexamic acid and microneedling worked better for melasma than other ways of using it.
PubMed 39574359 DOI
Assessing the efficacy of oral tranexamic acid as an adjuvant to triple combination topical treatment in melasma: a meta-analysis of randomized controlled trials.
Clinical and experimental dermatology2024Meta-analysis490 participantsPositive
A large review found that oral tranexamic acid added to a triple cream improved melasma and lowered its return, with no clear difference in redness or burning.
PubMed 38848545 DOI
Comparative efficacy and safety of tranexamic acid for melasma by different administration methods: A systematic review and network meta-analysis.
Journal of cosmetic dermatology2024Meta-analysisPositive
A large review of clinical trials found oral tranexamic acid with topical treatments reduced melasma more than other routes, while tranexamic acid alone worked similarly across routes over time.
PubMed 38059683 DOI
The efficacy and safety of microneedling with topical tranexamic acid for melasma treatment: A systematic review and meta-analysis.
Journal of cosmetic dermatology2024Meta-analysisPositive
A large review found microneedling with tranexamic acid reduced melasma severity, but it was not consistently better than routine treatments.
PubMed 37584240 DOI
Tranexamic acid as a therapeutic option for melasma management: meta-analysis and systematic review of randomized controlled trials.
The Journal of dermatological treatment2024Meta-analysis1,280 participantsPositive
A large review of many clinical trials involving 1,280 people found tranexamic acid reduced melasma severity, though side effects included stomach upset, skin irritation, and menstrual changes.
PubMed 38843906 DOI
Effectiveness of laser and topical tranexamic acid combination therapy in melasma: An updated systematic review and meta-analysis of randomized controlled trials.
Lasers in medical science2023Meta-analysisPositive
A large review of many clinical trials found that laser treatment with tranexamic acid used on the skin lowered melasma scores.
PubMed 37326860 DOI
Amber LED photobiomodulation versus tranexamic acid for the treatment of melasma: randomized controlled double-blind pilot trial.
Lasers in medical science2025RCT21 participants5%Mixed
In a 12-week trial of 21 women with melasma, tranexamic acid cream did not improve visible signs, but quality of life improved and some women felt burning.
PubMed 40650752 DOI
Comparative study of different treatment modalities for melasma: introducing a novel nanotechnology-based tranexamic acid microemulsion.
Archives of dermatological research2025RCT52 participants3% gel; 1% microemulsionPositive
In a five-month study of 52 women with melasma, tranexamic acid treatments improved melasma scores, and no recurrence was reported during follow-up.
PubMed 40455320 DOI
Randomized Clinical Trial on the Efficacy of Oral Tranexamic Acid Versus Topical Tranexamic Acid in Treatment of Melasma.
Journal of cosmetic dermatology2025RCT50 participants5%Positive
In a 12-week trial of 50 people with melasma, tranexamic acid taken by mouth or put on the skin reduced melasma severity, with no clear difference between them.
PubMed 40923777 DOI
Microneedling-assisted delivery of metformin versus tranexamic acid in treating melasma: a randomized controlled study.
European journal of medical research2025RCT45 participantsPositive
In an 8-week study of 45 women with melasma, microneedling with tranexamic acid reduced dark patches more than metformin or Kligman’s formula.
PubMed 40826371 DOI
Clinical study on the effectiveness of laser combined with topical tranexamic acid in the treatment of melasma.
Lasers in medical science2025RCT160 participantsPositive
In a study of 160 people with melasma, laser treatment with tranexamic acid put on the skin reduced dark patches more than laser alone.
PubMed 40970991 DOI
Safety and efficacy of niosomal and conventional tranexamic acid/niacinamide vs. hydroquinone creams in melasma: A randomized, double-blind, case-controlled clinical trial.
Scientific reports2025RCT99 participants2% (niosomal); 5% (conventional)Positive
In a 3-month study of 99 people with melasma, tranexamic acid and niacinamide creams reduced dark patches and improved quality of life as much as hydroquinone cream.
PubMed 41315336 DOI
Treatment of Melasma with Tranexamic Acid Essence Combined with Iontophoresis: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.
Drug design, development and therapy2024RCT30 participantsPositive
In a three-month trial of 30 people, tranexamic acid used with iontophoresis improved melasma scores and skin brightness more than a placebo.
PubMed 39185080 DOI
The effectiveness and safety of 3% tranexamic acid cream vs. 4% hydroquinone cream for mixed-type melasma in skin of color: a double-blind, split-face, randomized controlled trial.
Acta dermatovenerologica Alpina, Pannonica, et Adriatica2024RCT20 participants3%Positive
In an 8-week study of 20 people with melasma, tranexamic acid cream reduced melasma severity, with similar patient-rated improvement to hydroquinone cream.
PubMed 38918942
Safety and efficacy of a picosecond 755-nm alexandrite laser combined with topical tranexamic acid in the treatment of melasma.
Journal of cosmetic dermatology2024RCT35 participantsPositive
In a trial of 35 people, adding tranexamic acid to laser treatment improved melasma more and brought higher satisfaction than laser alone.
PubMed 39234928 DOI
Efficacy, Safety, Satisfaction, Adherence to Treatment With Nano-Formulated Cysteamine Tranexamic Acid Cream to Treat Melasma.
Journal of drugs in dermatology : JDD2024RCT50 participantsPositive
In a 3-month study of 50 people, a cream with tranexamic acid and cysteamine improved melasma, and participants reported satisfaction.
PubMed 38954613 DOI
Efficacy, safety, tolerability and treatment durability of microneedling plus topical tranexamic acid in combination with topical modified Kligman lightening formula for melasma: A four-arm assessor and analyst blinded randomized controlled clinical trial.
Journal of cosmetic dermatology2024RCT50 participants4% and 10%Positive
Microneedling with tranexamic acid worked better alongside a lightening treatment, but the benefits faded after treatment stopped.
PubMed 39016678 DOI
Efficacy and Tolerability of a Topical Pigment-Correcting Serum in Melasma and Postinflammatory Hyperpigmentation.
Journal of drugs in dermatology : JDD2026Clinical trial30 participantsPositive
In a 16-week study of 30 women, a serum with tranexamic acid and other ingredients improved dark patches, uneven tone, and roughness.
PubMed 42406361 DOI

Research context, not treatment advice. Studies are about the ingredient, not any one product.

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Products with Tranexamic Acid

Products we have confirmed contain Tranexamic Acid, from their ingredient lists.