Tranexamic Acid vs Azelaic Acid, Which is Better for Hyperpigmentation?

Hyperpigmentation is one of the most common skin concerns. It affects people of all ages and skin tones. There’s a huge variety of available skincare products and treatments all promising to brighten and even out the complexion. Despite all this, it is also one of the most difficult conditions to treat. One of the main reasons for this is that not all hyperpigmentation is the same in terms of causes, depth and location. Taking this into account can make finding the right treatments easier. Of the most popular ingredients for hyperpigmentation, both tranexamic and azelaic acid are widely sold for skin brightening and fading uneven tone. However, they work in different ways and this affects their uses. In this article, we explore tranexamic acid vs azelaic acid for hyperpigmentation and how to decide which is right for your skin.

What is Tranexamic Acid?

Tranexamic acid has become increasingly popular in recent years for treating melasma and stubborn hyperpigmentation. Originally used as an oral medicine to help reduce bleeding, researchers noticed its ability to interfere with some of the inflammatory pathways that lead to excess pigment. Since then studies have shown that when used consistently, tranexamic acid can help fade dark patches and reduce relapses. Its main benefits include:

• Calming inflammation: It helps reduce inflammatory signals that stimulate melanocytes during flare-ups and hormonal shifts.
• Interrupting pigment pathways: It interferes with the conversion steps that trigger excess melanin production, particularly in melasma.
• Reducing vascular changes: Melasma often involves increased blood vessel activity. Tranexamic acid may help reduce this, which improves the appearance of patches.
• Maintenance support: When combined with sunscreen, it can help reduce the frequency and intensity of melasma relapses.

These days, tranexamic acid is widely available in over-the-counter serums and creams in concentrations of 2-5% without prescription. It is also available by prescription in compounded topical skincare products, oral tablets and even as injectable treatments for severe melasma.

What is Azelaic Acid?

Azelaic acid is a naturally occurring dicarboxylic acid that is used in acne, rosacea and hyperpigmentation treatments. It is one of the most versatile and well tolerated brightening ingredients, especially for those prone to inflammation. Its main benefits include:

• Reducing melanin production: It gently inhibits tyrosinase, which helps fade brown marks and uneven tone.
• Clearing congestion: It helps prevent clogged pores and reduces the likelihood of new post inflammatory hyperpigmentation (PIH) from acne.
• Calming redness: Its anti-inflammatory properties make it suitable for rosacea-prone or easily irritated skin.
• Supporting texture: It offers mild exfoliating benefits which helps improve dullness and roughness.

Unlike tranexamic acid, azelaic acid is available only as a topical skin treatment. You can get azelaic acid in over the counter cleansers, serums, toners and lotions at concentrations of up to 10%. It is also available in prescription lotions, gels or creams in concentrations of up to 15-20%.

Which One is Better for Hyperpigmentation?

As you can see both tranexamic and azleaic acid have a number of skin benefits. When comparing tranexamic vs azleaic acid, the right choice depends mainly depends on the type of hyperpigmentation you’re treating. It is also worth taking into account how sensitive your skin is. Below is our head to head comparison of these two power house skincare ingredients for hyperpigmentation:

• Melasma: Tranexamic acid tends to perform better than azelaic acid for hormonally driven hyperpigmentation. It helps reduce relapses and is a good option for those who cannot use hydroquinone or strong actives like tretinoin or who alongside them as an adjunct.
• Post-inflammatory hyperpigmentation: Azelaic acid is usually more effective for acne-related dark marks because it treats both the pigment and the underlying inflammation. It also helps prevent new marks by reducing breakouts.
• Pigmentation with redness: Here, azelaic acid is often the better option because of its anti-inflammatory and rosacea-friendly actions.
• Sensitive or reactive skin: Azelaic acid (especially 10% or lower) is generally easier to tolerate for most skin types.

Ultimately, it is worth mentioning there no universal “better” ingredient. The best ingredient is the one that suits your skin type and targets the triggers and processes driving your hyperpigmentation.

Can You Use Tranexamic Acid and Azelaic Acid Together?

Although they work through separate mechanisms, there are times when it makes sense to use tranexamic and azelaic acid together. This is mainly beneficial when there is:

• Multi-factorial Hyperpigmentation: For example if you have post inflmmatory hyperpigmenattion and melasma then targeting them with both products make more sense. It allows targeting of acne, post acne txture and marks as well as the hyperpigmentation.
• Severe Melasma: Both ingredients work well together to suppress inflammation and reduce pigment formation.
• Reactive or sensitive skin: You can use both together to provide pigment control in melasma for skin unable to tolerate retinoids, strong acids or hydroquinone.
• Uneven tone with texture issues: Azelaic acid improves mild roughness and congestion while tranexamic acid focuses on pigment suppression.

How you combine them depends on your skin’s tolerance and what else is in your skincare routine. As a general rule:

• Use separately: A common routine is to use one in the morning and one in the evening. For example use azelaic acid in the morning to calm acne, inflammation and prevent new marks and by tranexamic acid in the evening to target melasma.
• Use together: If your skin is comfortable with both, apply azelaic acid first, allow it to settle, then follow with tranexamic acid. Depending on strengths, you can usually use both twice a day. Keep the remainder of the routine simple with hydrating serums and a barrier-supportive moisturiser.
• Use alternately: If your skin is sensitive or you use lots of other active ingredients, alternate days is usually a sensible way to introduce them.

Regardless of the method, a daily broad-spectrum sunscreen with at least SPF 30 is essential. Without UV protection, neither ingredient can perform effectively and hyperpigmentation can continue to darken.

Possible Risks of Tranxamic Acid vs Azleaic Acid

Inflammation can worsen hyperpigmentation (especially in medium to deeper skin tones). That’s why it is important to introduce new skincare ingredients carefully and monitor how your skin responds. Both tranexamic ad azelaic acid are generally well tolerated, but irritation is still possible depending on strength, formulation and what else is in your routine. As a general, these are the possible risks and side effects to be aware of:

• Tranexamic acid: Mild stinging or dryness can occur, especially with higher-strength compounded serums. It may feel tightening or cause temporary flushing if layered alongside strong actives. Combining it with exfoliating acids or retinoids can increase the risk of irritation, so it’s best to keep the routine simple when you first start. Oral tranexamic acid also has additional systemic side effects and risks. It is a prescription-only and should only be used under medical supervision.
• Azelaic acid: Tingling or light burning is common especially at concentrations of 15–20% and particularly during the first few weeks. It can also cause temporary dryness or flaking and may aggravate redness if the skin barrier is already compromised.

If you develop persistent redness, itching or worsening hyperpigmentation, reduce use or stop the product and adjust your skincare routine. If these symptoms are severe, there us allergic reaction or they do not resolve, seek medical help.

When comparing tranexamic acid vs azelaic acid, it is important to keep in mind that they work differently. Although both provide meaningful benefits for hyperpigmentation, they each have their own uses. Tranexamic acid performs best for melasma especially where there is deeper or relapsing hyperpigmentation. Azelaic acid is particularly helpful for acne-related dark marks, redness and sensitive skin. Neither works quickly and both require consistent use and strict sun protection to achieve visible improvement. It’s also not always a case of tranexamic acid vs azelaic acid as sometimes you may need to use both together.

At City Skin clinic, we are super passionate about personalised skincare. Our virtual skin clinic offers safe and effective custom skin treatments. Where appropriate our doctors use ingredients such as Tretinoin, Hydroquinone, Azelaic acid and Tranexamic acid to treat skin conditions like acne, hyperpigmentation, melasma and skin ageing. Start your online consultation today. The journey towards great skin starts here.

This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical provider for any medical concerns or questions you might have.