What should you know about tranexamic acid and melasma?

Tranexamic acid may help selected people with melasma, but it requires a dermatology assessment because route, duration, and clotting risks vary. Melasma causes patches of darker skin, often on the face, and can be influenced by light, hormones, and irritation. Tranexamic acid is not suitable for everyone; a dermatologist may consider it alongside sun protection and other pigment treatments after reviewing your history.

A clinician may discuss topical or oral tranexamic acid, depending on the pattern of pigmentation and your medical risks. The medicine is intended to influence processes involved in pigment production and inflammation; it does not erase the reason melasma developed. Colour can return when treatment stops or with renewed light exposure.

Use the prescribed product exactly as directed and follow the recommended light-protection routine, including broad-spectrum sunscreen and physical protection where appropriate. Tell the dermatologist about pregnancy, breastfeeding, previous blood clots, kidney disease, migraine symptoms, and medicines that affect clotting. Learn more at [Tranexamic Acid](/materials/tranexamic-acid/) and [Tranexamic Acid for Melasma](/treatments/medical-dermatology/tranexamic-acid-for-melasma/).

Seek urgent help for chest pain, breathlessness, coughing blood, one-sided leg swelling or pain, or sudden visual change while using tranexamic acid. Arrange a skin review for rapid change, bleeding, crusting, pain, or a patch that looks different from your established melasma.

Ask whether your pigmentation fits melasma, which route is being considered, how long the trial should last, what alternatives exist, and which clot-related symptoms require urgent action.