The melasma specialist — borrowed from medicine, with growing trial support for stubborn pigmentation.
Tranexamic acid interrupts the chemical conversation between UV-stressed surface cells and pigment cells (via the plasmin pathway), reducing the signal to overproduce melanin — a different, complementary route to most brighteners.
Topical trials used 2–5%.
Multiple trials show hydroquinone-comparable melasma results
Randomized trials found 3–5% topical tranexamic acid improved melasma comparably to 3–4% hydroquinone over 12 weeks, with better tolerability. Most trials are small and from a handful of research groups — good evidence trending toward strong.
Anchored to regulatory assessments — not hazard lists. Dose makes the poison; these are the conclusions at real-world cosmetic use.
Topical use is well tolerated in trials with minimal irritation. (The systemic clotting-related cautions of the oral drug don't meaningfully apply to cosmetic topical doses.)