What should you know about tranexamic acid for pigmentation?

Pigmentation can follow sun exposure, inflammation, hormones, or skin injury. Melasma often appears as patchy brown or grey-brown areas on the face and can become more noticeable with light and hormonal changes. Tranexamic acid is thought to reduce signals involved in pigment production, but it is not suitable for every mark or every person.

A clinician needs to identify the type of pigmentation before treatment. A changing, bleeding, crusted, or isolated dark spot should not be assumed to be cosmetic pigmentation.

Use daily broad-spectrum sun protection, seek shade, and avoid picking or irritating the area. Ask whether a topical product, procedure, or oral medicine is appropriate. Do not take tranexamic acid without medical advice, particularly if you have had a blood clot, have a clotting condition, kidney disease, vision symptoms, or use hormonal contraception.

The [Tranexamic Acid](/materials/tranexamic-acid/) page gives general background. For a treatment-focused overview, read [Tranexamic Acid for Melasma](/treatments/medical-dermatology/tranexamic-acid-for-melasma/).

Arrange a skin assessment for a new or rapidly changing mark, uneven colour with bleeding or crusting, or pigmentation that does not fit your usual pattern. Seek urgent help for chest pain, breathlessness, a painful swollen leg, or sudden vision changes while taking tranexamic acid.

What type of pigmentation do I have? Which route and duration are appropriate? How will we monitor for irritation, recurrence, or treatment-related risks?