What should you know about tranexamic acid use for melasma?

Melasma causes patches of darker skin, often on the cheeks, forehead, nose, or upper lip. Sunlight and hormonal changes can influence it. Tranexamic acid may affect signals involved in pigment production and may be included when a dermatologist considers it suitable.

It is not a general skin-whitening medicine and it will not correct every cause of facial discolouration. A clinician may first confirm that the patches fit melasma rather than another skin condition.

Use the prescribed formulation exactly as directed. A plan may use a topical product or another route, and the instructions for one must not be transferred to another. Tell the dermatologist about blood-clot history, kidney disease, vision symptoms, pregnancy, and hormonal medicines.

Daily broad-spectrum sun protection, shade, and a hat can help limit darkening from light exposure. Choose gentle cleansing and moisturising, and report persistent burning, rash, or swelling rather than adding more active products.

Seek urgent care for chest pain, difficulty breathing, coughing blood, one-sided leg swelling, sudden weakness, or a sudden change in vision. Contact the treating clinician for marked facial swelling, blistering, or a rapidly changing patch.

Ask how the diagnosis was made, which formulation is intended, how long the trial should last, what improvement would look like, and how the plan changes if pigmentation returns after treatment.