Tranexamic acid for skin treatments

Tranexamic acid works differently from other skin lightening ingredients to treat skin hyperpigmentation.

It can be combined with other skin whitening products in your skin care routine.

But- the best products have at least 1% TXA in them. This blog is all about how tranexamic acid works, and the best products for different skin types.

Find your skin type for free with our quiz!

Used in skin care for evening skin pigment by interfering with melanin in various ways.

No particular dangers unless you are allergic to it.

Well studied and increasing in popularity.

Tranexamic acid products

These days, there are more and more tranexamic acid products entering the market. It can be challenging to figure out which ones are the best. For that reason, I’ve put a few of my favorite tranexamic acid products for you here:

How does tranexamic acid (TXA) work on hyperpigmentation?

TXA blocks melanin production through a 3 step process:

Inhibits plasmin

Decreases tyrosinase activity in melanocytes

Reduces prostaglandin synthesis

It only works well on hyperpigmentation caused by increased blood flow to the skin. (at least that is the current belief but studies are ongoing.)

Who should use tranexamic acid for skin?

Tranexamic acid is use to treat hyperpigmentation. When used orally and topically it can improve:

melasma

post inflammatory hyperpigmentation (PIH) (4)

hyperpigmentation

solar lentigos

Topical tranexamic does not prevent PIH, but has been shown to speed clearing of post inflammatory pigmentation. (1)

Injected intradermal tranexamic acid has been shown to prevent PIH. (4)

Is tranexamic acid an exfoliant?

No. Tranexamic is not an exfoliant.

Hydroquinone

Is tranexamic acid as good as hydroquinone?

Hydroquinone is usually much more effective than TXA topically.

This is because topical TXA is usually a very low dose in cosmeceuticals while hydroquinone is prescription and is usually 4-10%.

TXA does not absorb as well into the skin as hydroquinone does.

In research trials that use 3-5% of TXA, we see that TXA might work as well as hydroquinone.

Here are the research studies:

2014: A randomized, split-face trial compared 3% topical TXA versus 3% HQ and 0.01% dexamethasone used twice daily for 12 weeks. The improvement was better in the TXA group but the difference was not statistically significant. (9)

2015: A study compared 5% TXA versus 4% HQ cream for the treatment of melasma and did not find a statistically significant difference between the 2 groups. (10)

2017: Another study in 2017 compared 5% TXA with 2% hydroquinone and did not show a statistical difference. (11)

Is oral TXA as good as hydroquinone?

Oral tranexamic acid is much more effective than topical hydroquinone for treating melasma.

The topical formulations of TXA are not as effective as TXA orally or injected into the skin.

TXA pills and injections work much better than hydroquinone.

What can you layer tranexamic acid with?

TXA does not tend to react with other ingredients so it can be mixed with retinol, AHA, BHA, hydroquinone, vitamin C, kojic acid, arbutin and other skin lightening ingredients.

Niacinamide

Tranexamic acid and niacinamide together?

These are good skin lightening ingredients to use together because they work in 2 different ways.

Retinol

Tranexamic acid and retinol together?

These are great ingredients to use together but they should be used at different times in your skin care routine.

Hyaluronic acid

Tranexamic acid and hyaluronic acid together?

It is a good idea to use HA serums and TXA together because:

TXA absorbs poorly

HA increases absorption of TXA into the skin

Is TXA right for you? When is the best time to use it in your skin care routine?

We can help you build the best skin care routine for your Baumann Skin Type.

How is Tranexamic acid used?

TXA is used in 3 main ways:

topically in skin serums and creams

injected into dark spots

orally in a tablet pill form

Topical Tranexamic Acid Serums and Creams

Topical TXA is included in skin care products with formulations at a dose of up to 5% (8).

The most effective TXA skin care products have at least 1% of TXA.

TXA absorbs poorly so the products that you combine with it in your skin care routine matters a lot!

intradermal tranexamic acid injections

Intradermal Tranexamic Acid

TXA is injected into skin and after microneedling i to treat dyschromia.

It comes in a liquid form and most protocols use 4–100 mg/mL.

Several studies have looked at intradermal TXA or TXA applied after microneedling, however there is no consensus on dose and how often to inject.

At this time it is too early to say if TXA is an effective treatment when used in this manner. (12)

Oral tranexamic acid for skin

Oral tranexamic acid is not approved by the FDA but it is often used to treat melasma.

It works by decreasing blood flow to the skin.

This means that TXA will NOT work on dark spots that are not caused by an increased blood flow.

Dose of the tranexamic acid pill for hyperpigmentation

The most commonly used dose of TXA for melasma is350 mg two times a day. a 600mg tablet is broken in half to give a dose of 350 mg.

Studies that show oral tranexamic acid is good for melasma

Many studies show oral TXA works well to treat melasma.

In one study, 44 patients with melasma took 250mg of TXA by mouth two times a day for 3 months. (7)

They had a 49% improvement of melasma as assessed by the MASI score.

Many other studies have shown efficacy as well.

are the effects of tranexamic acid permanent?

Are the skin lightening effects of oral tranexamic acid permanent?

It is unknown how long the skin whitening effects of TXA will last, but they are not permanent.

Melasma tends to recur and relapse. This is seen after TXA treatment as with any other melasma treatments.

In one study (7), 26% of patients continued to show improvement at 3 months (49% had improvement at end of the study)- so only about half still showed improvement at 3 months.

You can help prevent recurrence of melasma after stopping tranexamic acid with:

Two skin care routines for melasma- a maintenance regimen and a treatment regimen

Habits to minimize pigmentation and help get rid of melasma

Treating melasma from the inside with anti-inflammatory diet and supplements

How long should I take tranexamic acid for melasma?

There is no consensus on how long TXA should be used. Most doctors have you take it until melasma clears or for 3 months.

We do not know many things about using TXA for melasma:

Should be a treatment holiday?

How long it is safe to take?

How common is relapse?

How long after stopping tranexamic acid does it recur?

TXA is a promising medication for the treatment of melasma, but more studies and clinical experience is needed to determine the most effective treatment and maintenance protocols.

Side effects of oral tranexamic acid

The most common side effects are GI complaints such as nausea and diarrhea.

Blood clots are a risk with TXA, but clots have not to my knowledge been reported in patients taking TXA for melasma treatment.

risks of tranexamic acid

Contraindications to oral tranexamic acid

Oral TXA Tranexamic acid can increase the risk of blood clots when used orally.

Do not take the tranexamic acid pills if you:

are on estrogen containing oral contraceptives

are taking estrogen for hormone replacement therapy

have a history of blood clots

have an increased risk of blood clots

are planning a very long flight or time period of inactivity such as bed rest

are pregnant

Do not take tranexamic acid pills if you have any of these medical issues:

Acute promyelocytic leukemia patients on oral tretinoin

History of blood clots,

History of deep vein thrombosis

History of pulmonary embolism

History of stroke

Stroke

Kidney disease—The effects may be increased because of slower removal of the medicine from the body.

Pregnancy

Breastfeeding

Discuss with your doctor before taking TXA if you are on any of these because of increased risk of blood clots:

Desogestrel

Dienogest

Drospirenone

Estradiol

Ethinyl Estradiol

Ethynodiol

Etonogestrel

Gestodene

Levonorgestrel

Medroxyprogesterone

Mestranol

Nomegestrol

Norelgestromin

Norethindrone

Norgestimate

Norgestrel

Segesterone

The best way to know if oral or injected TXA is a good option for you is to see one of our doctors or medical providers.

Other names for tranexamic acid

Trans-4-aminomethylcyclohexanecarboxylic acid

trans-AMCHA

TXA

Melasma pill

Melasma tablet

Wondering if topical TXA is good for your skin type?

Take our free quiz and find out today!

DQH Can I use salicylic acid first and then vitamin C? It’s easy to create a skincare routine, but knowing how to use it is another thing entirely. In most cases, if you’re not getting the desired skin results, it could be due to the layering of conflicting ingredients. So, is it possible that salicylic acid and vitamin C are such ingredients? Or are these active ingredients the duo that’s been missing from your skincare routine? If you want answers, stick around because today we are going to explain the benefits of salicylic acid and vitamin C and how they can be used in your daily life. What are the benefits of salicylic acid for skin? Salicylic acid is one of the most commonly used beta hydroxy acids and is favored by many people with oily, acne-prone skin. This acid is derived from willow bark, and unlike its water-soluble relatives (called alpha-hydroxy acids), salicylic acid is oil-soluble, which means it can penetrate deeper into the lower layers of the skin. Once it reaches the lower layers, it can help unclog pores of excess sebum, dirt, bacteria, debris, and impurities. This results in clearer skin tones and greater definition. Not only does salicylic acid benefit the underlying layers, but the outer surface of the skin benefits as well. When applied to the skin, salicylic acid removes the buildup of dead skin cells. This is accomplished by breaking the bonds that hold dead cells to the surface. Over time, this can cause the complexion to look dull and prone to acne, blackheads, and other blemishes. If you’d like to learn more about salicylic acid and how it can improve your skin, check out this dedicated blog post from a beauty insider. What are the benefits of vitamin C for skin? Vitamin C is considered one of the most powerful antioxidants, which means it is very effective at fighting free radicals and preventing them from causing further skin damage. Examples of free radicals include pollution, central heating, UV rays and harsh climate. They attack proteins, fats and cell membranes as soon as they come into contact with the skin, causing signs of premature aging such as fine lines and wrinkles as well as hyperpigmentation, flaky patches of skin and loss of elasticity. Many people usually prefer to use vitamin C in their morning routine as this ingredient gives the complexion a radiant glow. You’ll also find that vitamin C can target areas of hyperpigmentation, plumping the skin and reducing the appearance of fine lines and wrinkles. The thing about vitamin C is that there are a lot of outdated studies going back to the 1950s that describe vitamin C as an unstable skin component. Thanks to improvements in modern technology, this is no longer the case as all products now contain a stable form of vitamin C. Visit The Beauty Insider to learn more about vitamin C. So please check out our blog post. Can I use salicylic acid first and then vitamin C? Yes, you absolutely can. In fact, it’s thought that using salicylic acid before using vitamin C ensures it penetrates faster and works faster. This is an efficient way to utilize two power sources, and the reason has to do with pH. For example, the skin’s natural pH is about 4.7, making it slightly acidic. Salicylic acid and vitamin C are also both acidic, and you’ll find that vitamin C is absorbed quickly into the skin. Therefore, using salicylic acid beforehand can increase the acidity of the skin and allow vitamin C to penetrate into the skin faster. While this is considered an effective way to combine two powerful ingredients, you need to be aware of your skin type and how it reacts to certain active ingredients. Even people with perfect, normal skin can experience skin sensitivity and irritation. Therefore, always consult a doctor or dermatologist before using any new products on your skin. It’s also important to follow skin application rules. In this case, you need to use the product correctly to ensure you get the best results for your skin. If you’re not sure what I mean, the basic rule for skin is to start with the thinnest consistency and work your way up to the thickest consistency. This prevents a barrier from forming on the surface, preventing other active ingredients from penetrating the skin. Can I use salicylic acid at night and vitamin C in the morning? Yes, absolutely, this is considered the most effective way to get returns without any adverse side effects. This is because there is enough time between applications to ensure that the skin’s pH levels return to balance. You’ll also find that Vitamin C is rich in antioxidants and is perfect for use in the morning to ensure your skin is protected and looking its healthiest. Due to the small size of salicylic acid molecules, it is an acid that is able to reach the deepest parts of the skin. While this is effective at keeping skin clear, it also increases the risk of irritation and photosensitivity. Therefore, many people prefer to use powerful BHAs in their evening routine without exposure to UV rays, pollution, or harsh weather. Warning: If you avoid using sunscreen every day, none of these ingredients will do what your skin needs. The combination of chemical peels and powerful ingredients increases the risk of further damage to the skin’s surface. Use SPF 50 every day to keep your skin protected and your lipid barrier healthy, even on cloudy days, keeping your skin in top condition.

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