POSTED: 31 Oct 2023

Tranexamic Acid Skincare, Is It Really A Game-Changer for Hyperpigmentation?

Hyperpigmentation is a common but difficult to treat skin condition that affects all skin types. The already crowded field of skincare is growing. Tranexamic acid is one such product that promises to treat hyperpigmentation and provide flawless, even toned skin. Since its introduction into skincare, Tranexamic acid has received rave reviews from skincare fans and dermatologists alike. However, is it really a game-changer or just another passing fad? In this article, we dive deep ino what is Tranexamic acid and how it works on skin. We explore Tranexamic acid’s benefits, limits, risks and how to use it in your skincare routine. We’ll also compare how it stacks up against other hyperpigmentation treatments like hydroquinone.

What is Tranexamic Acid & How Does It Benefit Skin?

Tranexamic acid belongs to a class of drugs known as anti-fibrinolytics. It was first discovered in 1962 by Japanese researchers Shosuke and Utako Okamoto. This drug works by stopping the breakdown of blood clots, thereby reducing or stopping excessive bleeding. For this reasons it is commonly used in to treat bleeding due to surgery, trauma, heavy menstrual flow and haemophilia. So you might wonder how, Tranexamic acid has found a calling in treating skin conditions like hyperpigmentation and melasma. Well like most things in skincare, its skin lightening effects were an incidental discovery.

The transition of Tranexamic acid from the medical field to the beauty industry is a story of scientific serendipity. In the 1970s, Dermatologists began noticing that patients taking Tranexamic acid for bleeding issues also experienced a significant fading in melasma hyperpigmentation. This unexpected side effect lead to further studies which eventually showed that Tranexamic acid was an effective treatment for various forms of hyperpigmentation, including melasma and post-inflammatory hyperpigmentation.

Since Tranexamic acid was shown to have benefits in treating stubborn hyperpigmentation, it was adopted into various skincare products. Today, it’s celebrated for its potent ability to treat pigmentation issues. This is why it is a sought after ingredient for those wanting an even toned, bright and glowing complexion.

How Tranexamic Treats Hyperpigmentation

Tranexamic acid treats hyperpigmentation through a multifocal approach. At its core, it works by disrupting the pathways that lead to excess melanin production, the pigment responsible for skin colour. When skin is exposed to triggers like sunlight or hormonal changes, it responds by ramping up melanin production. This often leads to uneven pigmentation. Tranexamic acid steps in to calm this response to ensure melanin production stays within a normal range. Specifically, it inhibits the interaction between melanocytes and keratinocytes. These are cells that play a key role in pigment formation. It also reduces the activity of tyrosinase, an enzyme vital for making melanin. By disrupting these processes, it reduces melanin production. This leads to a reduction in the appearance of dark spots and uneven skin tone. Moreover, Tranexamic acid has anti-inflammatory properties. This helps in treating post-inflammatory hyperpigmentation by limiting the inflammatory response that can worsen pigment issues.

Safety & Side Effects

Topical Tranexamic acid is generally well tolerated and safe to use by most people looking to address hyperpigmentation. It is available over the counter in a variety of skin products. Most of the time, side effects are typically mild but may include:

  • Irritation: Some people may experience mild skin irritation, dryness or redness. It is important to perform a patch test before using and start slowly especially if you have sensitive skin.
  • Allergic Reactions: Though rare, allergic reactions are possible. Again, always check the ingredients list and perform a patch test before using any new skincare treatments.

Although Tranexamic acid is generally safe for most people, there may be situations when you should seek medical advice before trying. You should consult a dermatologist if you have severe hyperpigmentation, other skin conditions, take medications or medical problems. Pregnant or breast feeding women should avoid using it unless advised by a healthcare professional. People with a history of blood clots or clotting problems or who take blood thinners should also exercise caution. Speak with your doctor first before starting Tranexamic acid even if its in topical form on your skin.

Comparison with Other Hyperpigmentation Treatments

Tranexamic acid is a widely available and gentle over the counter skincare treatment for hyperpigmentation. However, how does it fair when stacked up against other well known hyperpigmentation treatments? Below we’ll compare and contrast Tranexamic acid with the most effective skin brightening treatments.

Hydroquinone

Tranexamic acid and hydroquinone work through unique pathways to fade hyperpigmentation. Hydroquinone is the most powerful skin-lightening agent and is a prescription medicine only treatment in the UK. It works by inhibiting the enzyme tyrosinase to reduce melanin production. Whilst highly effective against even severe hyperpigmentation, it can also lead to skin irritation and carries a risk of rebound hyperpigmentation and ochronosis if not used properly. On the other hand, Tranexamic acid reduces melanin synthesis by interfering with the interaction between melanocytes and keratinocytes. This makes it a gentler but less potent treatment. It is available over the counter and is particularly suitable for people with sensitive skin and milder hyperpigmentation.

Arbutin

This naturally derived compound also inhibits tyrosinase activity similarly to hydroquinone but is available over the counter. However, arbutin is a gentler and less powerful alternative to pure hydroquinone. It is best for those with more sensitive skin. Arbutin works best in those who need to fade mild or moderate hyperpigmentation and with lighter skin tones. Tranexamic acid is also gentle and is a great alternative for those who have not respond well to or wish to avoid tyrosinase inhibitors like hydroquinone or arbutin. It may also be better for post inflammatory hyperpigmentation or melasma.

Retinoids

Retinol and prescription retinoids like Tretinoin work by speeding up cell turnover and boosting collagen production. effectively removing the upper layers of skin where the hyperpigmented cells are. This process not only fades existing dark spots but also boosts overall skin texture and tone. Additionally, retinoids can prevent the transfer of pigment from melanocytes to skin cells. This adds another dimension to treat hyperpigmentation. Tranexamic acid does not directly influence cell turnover or skin exfoliation. It is a gentler and less potent option to fade hyperpigmentation. However, you don’t need to choose one or the other. Both retinoids and Tranexamic acid work well together to treat hyperpigmentation. If you have super sensitive skin that can’t handle retinoids, you can try Bakuchiol alongside Tranexamic acid instead.

Kojic Acid

Derived from fungi, Kojic acid is an over the counter skin ingredient that is well known for its skin-lightening properties. It works by inhibiting the activity of tyrosinase and hence reduces excess melanin production. As such, Kojic acid effectively treats hyperpigmentation. It can also prevent the formation of new pigmentation. It also has antioxidant properties and can protect against environmental damage. Whilst Kojic acid acts by directly inhibiting the key enzyme in melanin synthesis, Tranexamic acid targets the inflammatory pathways that lead to increased pigmentation. As such, Kojic acid may be better for general pigmentation concerns and overall skin brightening. On the other hand, Tranexamic acid skincare is specifically beneficial for hyperpigmentation linked to inflammatory conditions like melasma and post acne marks.

Vitamin C

This is a powerful antioxidant that is famous for its skin brightening effects. Vitamin C protects from sun induced skin damage and hyperpigmentation. It also boosts collagen production which improves the quality and texture of the skin. Whilst it can’t treat hyperpigmentation by itself, Vitamin C can protect the skin from oxidative stress and can enhance overall radiance. You can combine these two ingredients to enhance their effects.

Niacinamide

Also known as vitamin B3, Niacinamide has a number of skin benefits. One of these is that helps to reduce the appearance of hyperpigmentation by stopping the transfer of melanin to the skin’s surface. This can lead to a more even skin tone over time. Niacinamide is also known for its anti-inflammatory properties which makes it useful for those with acne prone or sensitive skin. Tranexamic acid is more effective for deeper and more stubborn hyperpigmentation such as melasma. Good news though is that Niacinamide and Tranexamic acid can work well together. Simply put, Niacinamide works on the surface level to prevent melanin transfer and enhance skin barrier. On the other hand, Tranexamic acid works at a deeper level to reduce melanin over production.

Glutathione

This is a potent antioxidant naturally produced in the body. Glutathione plays a crucial role in neutralising free radicals and preventing oxidative damage. It can inhibit the production of melanin and even out skin tone. As such it’s often used to brighten the skin and fade mildly dark spots or patches. Glutathione might be better for people dealing with dull skin or uneven tone. However, for those struggling with specific hyperpigmentation issues, Tranexamic acid could be more effective.

How to Use Tranexamic Acid in Your Skincare Routine

It is very easy to use Tranexamic acid but you should still pursue a sensible approach to ensure you get good results and avoid risks. Below are our top tips for starting:

  • Know Thyself: Think about your specific skin concern (e.g. melasma or post acne spots), severity and your goals. This will help decide whether it is right for you.
  • Set Up For Success: Use Tranexamic acid as part of a gentle and supportive routine. Your routine should include a cleanser, moisturiser and sunscreen. Later, you can add products like retinoids and Vitamin C.
  • Product: Tranexamic acid comes in a range of products. The best way to use it is in a serum or moisturiser in the mornings. If you have super sensitive skin then try it in a cleanser initially. If you have very oily skin, then you might prefer it in a toner or sunscreen.
  • Start Slow: Tranexamic acid should be used daily but you may want to start with a lower strength and frequency.
  • Patch Test: Always perform a patch test to rule out any adverse reactions.
  • Consistency: Regular use is crucial for visible results.
  • Manage Expectations: You need to use Tranexamic acid regularly for at least 6-8 weeks to start seeing any difference. Also results vary from person to person.
  • Ask For Help: If you have severe or stubborn hyperpigmentation, then you may need to see a skin doctor. The same is true if you have very sensitive skin, any skin conditions or medical problems.

Tranexamic acid is a great tool to add into your skincare routine for treating mild to moderate skin hyperpigmentation. It is widely available, gentle and can reduce dark spots to brighten and even out the skin. However, results take time and effort. They also vary from person to person. It is also not suitable for everyone and can cause some side effects. If you have stubborn hyperpigmentation, sensitive skin or medical problems, then it’s always wise to consult with a doctor before adding new active ingredients into your skincare routine.

At City Skin clinic, we are devoted to personalised skincare. Through our online skin clinic we connect you with our doctors for safe and effective skin treatments like Tretinoin and Hydroquinone. We treat conditions like acnehyperpigmentationmelasma and skin ageing. To get started on your personalised skin protocol, book a virtual video consultation or use our online consultation form. The journey towards great skin starts here.

Authored by:

Dr Amel Ibrahim
Aesthetic Doctor & Medical Director
BSC (HONS) MBBS MRCS PHD
Founder City Skin Clinic
Member of the Royal College of Surgeons of England
Associate Member of British Association of Body Sculpting GMC Registered - 7049611

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