As you consider treatment options for your melasma or hyperpigmentation concerns, you may be wondering if combining oral tranexamic acid and prescription topical creams could help you get better results faster. Keep reading to learn if this is a treatment option that could work for you.
Oral tranexamic acid reduces the production of melanin by inhibiting tyrosinase activity and altering cell interactions. A 12-week study of oral tranexamic acid treatments for melasma showed an average improvement rate of 49% according to the MASI scale (Del Rosario).
Prescription-strength topical creams generally work by interfering with melanin production, typically by reducing melanocytes – cells that produce melanin to protect the skin from UV rays when exposed to the sun.
The “gold standard” topical treatment for melasma is hydroquinone, a lightening agent. It is frequently used in combination with steroids or retinols to prevent skin irritation and increase efficacy. Multiple studies suggest that combination creams including a 4% concentration of hydroquinone, a steroid, and tretinoin (a retinoid) are the most effective (Grimes).
Depending on your skin’s needs, your doctor may recommend a combination of both oral tranexamic acid and prescription topical creams to address your melasma or hyperpigmentation issues.
One study examined a treatment plan of oral tranexamic acid and a 2% hydroquinone triple combination cream. The study found that oral and topical treatments combined led to faster and sustained improvement in melasma patients (Padhi).
Another study found that oral tranexamic acid combined with a 4% hydroquinone cream led to significantly higher patient satisfaction with progress in treating their melasma than topical treatments on their own (Tehranchinia).
Treatment plans typically last 8-12 weeks, though sometimes treatment can last much longer depending on the nature of your skin concerns.
Tranexamic acid has coagulative properties, which is why it’s also used to treat heavy menstruation. If you have a heart condition or issues with blood clotting, you should be sure to let your doctor know.
Other mild side effects that may occur with oral tranexamic acid include:
Hydroquinone and other topical treatments may cause some mild side effects that should subside once your skin adjusts to treatment, such as: