Raechele Cochran Gathers, MD Topical tranexamic acid is showing promise as a new treatment for dark spots on the skin
Topical tranexamic acid (TXA) is a treatment for dark spots and discoloration on the skin from melasma, acne scars, or other skin problems that may cause you to have dark patches, postinflammatory hyperpigmentation and an uneven complexion.
Topical tranexamic acid is being suggested by many clinicians as an alternative to hydroquinone and other skin lightening agents. Studies have indicated that topical tranexamic acid may be just as effective as topical hydroquinone, but without some of the side effects that can be seen with hydroquinones like redness and irritation. The effects of TXA seem to be improved even more with the use of microneedling devices. One study found that while melasma improved using TXA alone, adding a microneedling device once weekly faded dark spots even more.
What is Tranexamic Acid?
If you’ve suffered from excessively heavy periods (menorrhagia) or have a blood clotting disorder like hemophilia, you may have been treated with oral TXA. However, if you’re like most people, chances are you’ve never even heard about TXA. TXA is a man made form of a protein called lysine. TXA, when taken by mouth and injected, is a medicine that is given by doctors to prevent excessive blood loss.
How Tranexamic Acid Works
TXA inhibits the activation of an enzyme called plasminogen. When this happens the UV (ultraviolet light) formation of melanin decreases. That’s how it helps to treat dark spots. Also, like hydroquinone, TXA decreases the enzyme tyrosinase, which leads to decreased melanin and decreased skin darkening.
How to Use Tranexamic Acid
While some doctors do prescribe oral tranexamic acid to treat conditions like melasma, it is not approved by the FDA for this use. Taken by mouth, TXA can have side effects like blood clots in your lungs or body, called pulmonary embolism and DVT.
Topical TXA is an option for those looking for an alternative to hydroquinone products. One product that contains TXA is Naturium. This product contains 5% TXA . When treating your dark spots, always remember your sunscreen! One of my favorite moisturizers with sunscreen is Aveeno Positively Radiant with SPF 30. For those looking to avoid chemical sunscreens, another choice is Neutrogena Healthy Defense Sensitive Skin. It has a non chemical sunscreen that is good for those with sensitive skin.
Before you use any topical TXA or skin lightening product, consult with your dermatologist. There are many causes of skin discoloration, some of them very serious like lupus. Your dermatologist should examine your skin and take a history of your problem. Your dermatologist can guide you regarding whether topical TXA is a good choice for you to try.
