How To Combine Oral Tranexamic Acid And Other Treatments

If you are considering oral tranexamic acid to treat your hyperpigmentation or melasma issues, you may be wondering if you can safely combine it with other treatments to get results faster. Read on to learn more about combining oral tranexamic acid and other treatments.

How do oral tranexamic acid and other treatments work together?

Oral tranexamic acid alters cell interactions and inhibits tyrosinase, an enzyme necessary to make melanin. When exposed to UV light, cells called melanocytes produce melanin to protect the skin.

Prescription-strength topical creams are common treatments for melasma and hyperpigmentation issues. These medications also work by inhibiting melanin production. Hydroquinone, considered the “gold standard” in treating melasma and hyperpigmentation, may be found in monotherapy creams or in combination with other ingredients, such as retinols or steroids to increase efficacy and reduce the likelihood of skin irritation.

Using sunscreen daily is another way to protect the skin from UV rays, which in turn helps prevent an outbreak. Sunscreen should be used both during and after treatment for best results.

How effective is combining oral tranexamic acid with other treatments?

Studies reflect that combining oral tranexamic acid with topical treatments can lead to faster results. One study found that oral tranexamic acid and 2% triple combination cream led to faster improvement for melasma patients (Padhi).

Another study combining oral tranexamic acid with a 4% hydroquinone cream resulted in significantly higher patient satisfaction than with topical medications only (Tehranchinia).

Are there any side effects of combining oral tranexamic acid with other treatments?

Those who have heart conditions or blood disorders should be sure to disclose these issues to your doctor to ensure you can safely take oral tranexamic acid as it has coagulative properties.

Other side effects of tranexamic acid include:

• Lip or periorbital swelling
• Headache and tinnitus
• Abdominal pain, nausea, bloating, or vomiting
• Numbness or itchiness in the face, lips, fingers, or toes

There are a number of topical treatments for hyperpigmentation or melasma, but side effects are typically temporary and mild, such as:

• UV light/sun sensitivity
• Dry, red, stinging skin
• Tenderness in the application area

References

• Padhi T, Pradhan S. Oral Tranexamic Acid with Fluocinolone-Based Triple Combination Cream Versus Fluocinolone-Based Triple Combination Cream Alone in Melasma: An Open Labeled Randomized Comparative Trial. Indian J Dermatol. 2015;60(5):520. doi:10.4103/0019-5154.164416
• Tehranchinia Z, Saghi B, Rahimi H. Evaluation of Therapeutic Efficacy and Safety of Tranexamic Acid Local Infiltration in Combination with Topical 4% Hydroquinone Cream Compared to Topical 4% Hydroquinone Cream Alone in Patients with Melasma: A Split-Face Study. Dermatol Res Pract. 2018;2018:8350317. Published 2018 Jul 2. doi:10.1155/2018/8350317

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Brandon Kirsch, MD

Brandon Kirsch, MD, FAAD, is a board-certified dermatologist specializing in clinical drug development and medical innovation. He is the founder of Kirsch Dermatology in Naples, Florida and is also the Chief of Dermatology at the Naples Community Hospital.