Doctor’s Note: Your Essential Guide to Tranexamic Acid

As dermatologists, we often recommend tranexamic acid for treating dark spots and uneven skin tone. Originally used in medical settings, it’s now a popular skincare ingredient for achieving a more even complexion. This guide covers what tranexamic acid is, how it works on the skin, who benefits most, and tips for using it effectively!

What is Tranexamic Acid?

Tranexamic acid is a medicine that helps improve skin discoloration. Originally, doctors used it in hospitals to stop bleeding, but now it’s also used in skincare. It works by reducing the amount of melanin (pigment) your skin makes, which can help lighten dark spots, melasma, and other uneven skin tones.

What is Tranexamic Acid Used For?

Tranexamic acid can be confusing because it’s used for wildly different purposes. There’s a HUGE difference between the pill form and topical form. High dose oral tranexamic acid controls bleeding. Lose dose oral tranexamic acid reduces dark spots on the skin. Topical tranexamic acid is available over-the-counter that is used to lighten dark spots. Here is a summary:

Heavy Periods

High Dose Oral Tranexamic Acid
(3,000mg/day)

Oral tranexamic acid can reduce blood flow for people with heavy menstrual bleeding. It can also be given in the hospital to stop surgical or emergency bleeding.

Dark Spots Cartoon

Low Dose Oral Tranexamic Acid
(650mg/day)

Low dose oral tranexamic acid is used to treat skin conditions like melasma to help even out skin color.

Tranexamic Acid

Topical Tranexamic Acid

Topical tranexamic acid is available over-the-counter to treat skin conditions like melasma to help reduce dark spots and even out skin tone.

How Does Tranexamic Acid Work?

As we can see, tranexamic acid treats… blood loss and dark spots? wtf. How are those two things related? Let’s get into it!! To understand how tranexamic acid works, we need to understand the melanocyte (the cell that makes our pigment). Here is a over brief overview of the melanocyte and how pigment is made. Then, we can stop this process (thereby decreasing dark spots):

Melanocyte - How to Make Pigment

4 Steps to Make Pigment

  1. Getting Nutrients: Melanocytes need oxygen and nutrients to function.

  2. Making Melanin: Melanocytes create pigment (melanin) using an enzyme called tyrosinase.

  3. Moving Melanin: Melanin moves from melanocytes to the skin's surface in 28 days.

  4. Reaching the Surface: Melanin protects against UV damage and adds to skin color.

Melanocyte - How to Stop Making Pigment

Let’s Stop These Steps

  1. Getting Nutrients: Tranexamic acid blocks melanocytes from getting oxygen and nutrients.

  2. Making Melanin: Hydroquinone is the strongest ingredient that stops the enzyme tyrosinase.

  3. Moving Melanin: Retinol and niacinamide prevent pigment from moving to the top of skin.

  4. Reaching the Surface: Retinol gets rid of old, pigmented cells to brighten skin.

Benefits of Using Tranexamic Acid

Here’s what tranexamic acid can do for your skin:

  • Lightens Dark Spots: Tranexamic acid visibly lightens dark spots caused by sun damage, melasma, and acne scars. Many products, like the Acure Brightening Tranexamic Acid Serum and the Cos De Baha Tranexamic Acid Serum, are specifically made to reduce discoloration.

  • Brightens Skin Tone: Regular use of tranexamic acid can make your skin look brighter and more even.

  • Gentle on Sensitive Skin: Unlike other brightening treatments, tranexamic acid is often gentle enough for people with sensitive skin. Popular options, such as the Inkey List Tranexamic Acid and the Naturium Tranexamic Acid Serum, are designed to be mild yet effective.

Who Should Use Tranexamic Acid?

Tranexamic acid is useful for many skin types, especially if you’re dealing with discoloration or uneven skin tone:

Dark Spots Up Close

Uneven Tone

If you have uneven skin tone, dark spots, or melasma, tranexamic acid can help brighten these areas.

Dark Spot Up Close

Melasma

Melasma is a condition that causes dark patches on the skin. Tranexamic acid, available in both topical forms like TXA serums and oral tablets, is often used to help reduce melasma. An oral form, such as the Tranexamic Acid 650 mg Tablet, may be prescribed by a dermatologist for melasma.

Sensitive Skin Up Close

Sensitive Skin

Tranexamic acid is gentler than other brightening ingredients, so it’s often better for sensitive skin types.

How to Use Tranexamic Acid in Your Skin Care Routine

If you’re adding tranexamic acid to your routine, it’s best to start slowly and follow a few simple steps:

  1. Clean Your Face First: Use a gentle face wash.

  2. Apply Tranexamic Acid Serum: After cleansing, apply tranexamic acid directly to dark spots or to areas with uneven tone. Some people wonder, Does tranexamic acid cause purging? In most cases, it does not; however, if you experience irritation, try using it less often.

  3. Follow with Moisturizer and Sunscreen: Apply a moisturizer and finish with sunscreen during the day to protect against sun damage.

  4. Use at Night, if Possible: Tranexamic acid can be used day or night, but some dermatologists recommend using it at night to avoid any sensitivity.

  5. Avoid Mixing Too Many Actives: Tranexamic acid is gentle, but for best results, avoid layering it with other strong ingredients like retinoids without professional advice. Can I use tranexamic acid with retinol? Yes, but use them at different times of the day to reduce the risk of irritation.

Best Tranexamic Acid Serums

If you're looking for tranexamic acid serums to help even out your skin tone, there are some great options to try. Naturium Tranexamic Acid is known for its gentle formula that targets dark spots. The Inkey List Tranexamic Acid is affordable and combines tranexamic acid with other ingredients to brighten the skin. Acure Brightening Tranexamic Acid Serum includes tranexamic acid in a gentle formula. Cos De Baha Tranexamic Acid is a simple but effective option, focusing on fading dark spots and improving skin tone. These serums can be helpful for anyone dealing with uneven skin tone or dark spots.

Tranexamic Acid vs. Other Brightening Ingredients

Here’s how tranexamic acid compares to other popular ingredients for brightening skin:

  • Hydroquinone: Hydroquinone is MUCH stronger at lightening dark spots, but it can cause irritation (there are other side effects as well). Tranexamic acid is a milder option for those who want a gentler treatment.

  • Vitamin C: Vitamin C is another popular brightening ingredient, but it can be unstable and cause irritation. Tranexamic acid works well as an alternative or alongside vitamin C.

  • Niacinamide: Like tranexamic acid, niacinamide helps with dark spots and has calming properties. These two ingredients can complement each other for sensitive skin types.

  • Azelaic acid vs tranexamic acid: Both ingredients help with dark spots and pigmentation, but azelaic acid is also effective for acne. Tranexamic acid is generally better for melasma, while azelaic acid is often a top choice for those with both acne and dark spots.

Are There Any Side Effects?

Tranexamic acid is usually gentle on the skin, but here are a few things to watch for:

  • Redness or Irritation: A small percentage of people may experience redness or dryness. If this happens, try using it less frequently or consult a dermatologist.

  • Sun Sensitivity: Although tranexamic acid itself doesn’t cause sun sensitivity, it’s still wise to wear sunscreen while using brightening products to prevent further dark spots.

Sensitivity

Tranexamic Acid FAQ

What is tranexamic acid?
Tranexamic acid is a medication primarily used to prevent or reduce excessive bleeding. In skincare, it is a powerful ingredient known for reducing hyperpigmentation and improving skin tone.

How does tranexamic acid work?
Tranexamic acid works by inhibiting the production of plasmin, which reduces inflammation and pigment production in the skin. This makes it effective for treating melasma and dark spots.

What is tranexamic acid used for?
Tranexamic acid is used to treat heavy menstrual bleeding, nosebleeds, and bleeding after surgeries. In skincare, it is used to reduce hyperpigmentation, melasma, and dark spots.

Where to buy tranexamic acid over the counter?
Tranexamic acid is available over the counter in many skincare products, often found at drugstores, online retailers, or beauty stores. Popular brands include The Ordinary, Murad, and SkinCeuticals.

Can I use tranexamic acid with retinol?
Yes, tranexamic acid can be safely used with retinol. Apply tranexamic acid first (as it is often water-based) and follow with retinol. Start with alternating nights if your skin is sensitive.

What does tranexamic acid do for skin?
Tranexamic acid helps improve skin tone, reduce dark spots, and treat melasma by targeting pigment production. It is also anti-inflammatory, making it suitable for sensitive skin.

Does tranexamic acid cause purging?
No, tranexamic acid does not typically cause purging. However, if combined with other active ingredients or if your skin is sensitive, mild irritation may occur.

Is tranexamic acid safe in pregnancy?
Tranexamic acid for oral use is generally not recommended during pregnancy unless prescribed by a doctor. For topical skincare use, consult with your healthcare provider before adding it to your routine.