Is Tranexamic Acid Worth The Hype?

Acids continue to play a starring role in the skin care realm, thanks to their many complexion-enhancing benefits.

Haven’t come across tranexamic acid yet? This lesser known acid appears to have benefits for treating melasma, hyperpigmentation, and other types of skin discoloration.

Tranexamic acid comes from the amino acid lysine. Traditionally, it’s been used as an oral medication for heavy menstrual bleeding.

But when applied topically, it can alter the way cells produce melanin, the pigment that gives your skin color, according to Mary Stevenson, MD, assistant professor of dermatology at NYU Langone Health.

Basically, it interrupts pathways in the skin that might otherwise lead to an uneven skin tone.

Here’s what to know about this promising skin care ingredient before trying it yourself.

What are the benefits?

Studies suggest tranexamic acid may offer several skin benefits.

Stronger skin barrier

The skin barrier, or outermost layer of your skin, serves as a shield that helps keep moisture in and toxins and irritants out.

For people living with rosacea, 2020 research suggests this barrier is often damaged to the point where it doesn’t work properly. According to a 2016 reviewTrusted Source, strengthening the skin barrier can significantly reduce rosacea symptoms.

In a small 2015 study, people who applied a 3 percent tranexamic acid treatment to their skin for 2 weeks showed fewer visible signs of rosacea than those who didn’t use this treatment. Researchers linked this reduction in symptoms to improved skin barrier function.

Reduced dark spots and discoloration

“Tranexamic acid for the skin can act as a brightening agent to reduce dark spots and improve hyperpigmentation,” says Anna Guanche, MD, a board certified dermatologist and founder of the Bella Skin Institute. “This is because tranexamic acid interferes with melanin production.”

One 2019 studyTrusted Source explored the benefits of two different treatments for melasma, a common skin condition that can cause brown or gray patches of discoloration on the face. Participants used one of two topical treatments: tranexamic acid or hydroquinone, a lightening agent that bleaches the skin.

After 12 weeks, the severity of melasma decreased by 27 percent in the group using tranexamic acid — about the same as it did for those using hydroquinone. But the participants who used tranexamic acid reported higher satisfaction with their treatment, due to fewer side effects like skin irritation.

Reduced discoloration after acne breakouts and sun damage

Sometimes, acne breakouts can cause post-inflammatory erythema. These are stubborn red, pink, or purple patches of discoloration.

A 2022 reviewTrusted Source notes that tranexamic acid appears helpful for lessening the appearance of these lesions, with little risk of serious side effects.

A small 2021 studyTrusted Source also suggests that tranexamic acid could help improve skin tone and reduce sun-related redness and dark spots.

Participants applied cetyl tranexamate mesylate, a derivative of tranexamic acid, twice per day for 8 weeks. After just 2 weeks, most participants already reported improvements in skin tone, redness, and dark spots. They noticed continued improvement throughout the study.

Can anyone use it?

Tranexamic acid is generally safe for all skin types, according to Guanche.

To date, no evidence suggests this ingredient can be harmful during pregnancy. That said, very little research exploring its impact during pregnancy exists, says Aimee Paik, MD, senior vice president of dermatology at the telehealth company Hims & Hers.

If you’re pregnant, it’s always best to talk with your care team about trying any new medications, including topical skin care products you can purchase over the counter.

If you have sensitive skin or eczema, it never hurts to proceed with caution. Tranexamic acid may cause some irritation, particularly when you first start using it, explains Hadley King, MD, a board certified dermatologist and clinical instructor at the Weill Medical College of Cornell University.

That’s why King recommends doing a patch test on a small, discreet area of skin before applying a new product to your entire face.

How to do a patch test
Patch testing is always a good idea when trying any new skin care product. This test helps you check for possible allergies or sensitivities before you start using a product on your entire face.
Choose an area of skin near where you plan to use the product. If it’s a body lotion, you might apply it to your wrist or inner elbow. For a face product, you might choose a spot along your jaw or behind your ear.
Apply the product to a small patch of skin.
Leave the area alone for 1 or 2 days.
If you don’t notice any irritation, discoloration, or itchiness after 24 to 48 hours, you can most likely use the product safely.

Potential risks and side effects

You run a higher risk of side effects when taking tranexamic acid orally or through injections than when applying it topically, says Guanche.

When it comes to skin care products with tranexamic acid, a small 2014 studyTrusted Source found that the most common side effects include:

dryness
irritation
flaking

You can address dryness and flaking by always applying a rich moisturizer after using products with tranexamic acid. As for irritation, it often goes away after your skin adjusts to the ingredient.

When dryness, irritation, or flaking persist for more than a couple of weeks, it’s generally a good idea to stop using the product and connect with a dermatologist.

You’ll also want to get guidance from a healthcare professional if you experience more severe side effects, like:

persistent skin discoloration
itching
swelling or hive

Adding tranexamic acid to your skin care routine

You can use tranexamic acid at any time of day. Guanche recommends adding products with tranexamic acid to your evening skin care routine.

Paik advises using it after cleansing your skin and before applying moisturizer.

It’s important to introduce new products with active ingredients slowly, Guanche cautions, particularly if you have sensitive skin.

At first, try applying tranexamic acid just twice per week to see how your skin responds. If your skin seems to tolerate it well, you can gradually increase your use to every other night or every night.

Using tranexamic acid alongside products with kojic acid and phytic acid may improve your results, King says. She adds, though, that using tranexamic acid with other acids can cause dryness and irritation. Check with a dermatologist before combining multiple acids, or other skin care ingredients.

According to Stevenson, tranexamic acid works especially well when used in combination with other brightening agents like niacinamide and vitamin C.

You can also use it in combination with retinoids. Guanche notes that it can actually maximize the skin-enhancing benefits of these vitamin A derivatives, including helping fade sunspots and age spots.

It can take up to 1 month, if not longer, before you notice the full extent of results. King says that many people will start to notice a visible improvement as early as 2 weeks in.

Products to try

As more skin care products containing tranexamic acid hit the market, you might wonder which to choose.

As with any product, the right one for you can depend on your specific skin goals and concerns.

A few dermatologist-recommended options include:

SkinMedica Lytera 2.0 Pigment Correcting Serum contains a potent combo of tranexamic acid and phytic acid. It can help lessen the appearance of dark patches and promote a more even, radiant complexion, King says.
Skinceuticals Discoloration Defense contains kojic acid along with tranexamic acid. This ingredient can also help address skin discoloration. King notes that it’s also formulated with niacinamide, which can help improve skin tone and texture.
Paula’s Choice Clinical Discoloration Repair Serum is Paik’s recommendation. That’s because 2013 evidenceTrusted Source suggests a combination of tranexamic acid and niacinamide may help visibly reduce dark spots. Plus, it contains bakuchiol, a plant extract that further helps to target the root causes of unwanted color changes in your skin.
Naturium Tranexamic Topical Acid 5% has a higher percentage of tranexamic acid. That means it may prove more effective for stubborn or widespread discoloration, Paik says.

The bottom line

Tranexamic acid, a relative newcomer to the world of skin care, shows a lot of promise for treating melasma, sunspots, age spots, and other kinds of discoloration. What’s more, experts generally consider it safe for all skin types, and it tends to have few side effects.

Still, it’s always worth consulting with a dermatologist before adding tranexamic acid or any new ingredient to your routine. A trained professional can help you determine whether an ingredient is a good fit for your specific skin concerns and goals.

And again, whenever you try products with a new ingredient, make sure to do a patch test first and introduce the product into your routine gradually.

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