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Study summary · Skin, hair & photoaging

What are the various delivery methods of tranexamic acid (TXA) for treating melasma, and how effective are they compared to traditional treatments?

In one paragraph

Topical Tranexamic Acid Serum (J Cosmet Dermatol 2023, PMID 36606378) — oral TXA was the most effective, particularly for refractory melasma, but was associated with gastrointestinal upset and menstrual irregularities. No numeric effect size is reported for Topical Tranexamic Acid Serum in the source abstract.

Source: J Cosmet Dermatol 2023, PMID 36606378 ↗ · Research map · How Magellan grades evidence · evidence confidence: low

J Cosmet Dermatol · 2023 · PMID 36606378 · DOI 10.1111/jocd.15589

Plain-English summary written and published by Magellan Longevity · medical review by Gabriel Radu, DO (physiatrist, NPI 1376861765). We summarize what the paper reported — we did not run this study.

The takeaway

Tranexamic acid effectively treats melasma through various delivery methods, with oral TXA being most potent but having side effects, and topical TXA being well-tolerated.

The question

What are the various delivery methods of tranexamic acid (TXA) for treating melasma, and how effective are they compared to traditional treatments?

What they tested

The study aims to characterize the efficacy of different TXA delivery methods for melasma treatment.

How they did it

A comprehensive review of the literature was conducted using PubMed and Embase in May 2022. The search terms used were 'tranexamic acid' and 'melasma'. Forty-six articles were included in the review.

What they found

Oral, intralesional, and topical TXA were found to be safe and effective treatments for melasma, with overall improvement in MASI scores. Oral TXA was the most effective, particularly for refractory melasma, but was associated with gastrointestinal upset and menstrual irregularities. Intralesional injections and microneedling with topical TXA were effective alternatives. Topical TXA alone was the least effective but showed better tolerability than hydroquinone.

What it means

Tranexamic acid, delivered orally, intralesionally, or topically, is an effective treatment for melasma, with oral administration being the most potent despite side effects. Topical TXA is better tolerated than hydroquinone.

Limitations

The pro-thrombotic nature of oral TXA must be considered before prescribing. The review did not specify the exact number of patients experiencing side effects or the specific MASI score improvements for each method.

“topical tranexamic acid can improve outcomes and is better tolerated than hydroquinone”— from the published abstract, J Cosmet Dermatol 2023

The paper at a glance

Magellan’s evidence labelinhibits plasmin, reduces melanin (our label for this citation — see PubMed for the paper’s own title and authors)
JournalJ Cosmet Dermatol
Year2023
PMID36606378 ↗
DOI10.1111/jocd.15589 ↗
TopicSkin, hair & photoaging

Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗

Where Magellan uses this paper

This citation sits behind the evidence grade on the pages below. Grades are set from the research and are independent of affiliate commissions.

Topical Tranexamic Acid Serum

In randomized controlled trials and multiple meta-analyses, topical tranexamic acid significantly lowers melasma severity scores (MASI/mMASI and melanin index) and performs comparably to the long-standing standard agent hydroquinone, frequently with fewer irritant side effects;

Topical Tranexamic Acid Serum

Topical tranexamic acid (TXA; trans-4-aminomethylcyclohexanecarboxylic acid) is a synthetic lysine…

Check price on Amazon ↗

Research describes the compound or intervention studied. It is not a claim about any specific product.

Cite this page

These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.

APA
Magellan Longevity. (2026). What are the various delivery methods of tranexamic acid (TXA) for treating melasma, and how effective are they compared to traditional treatments? [Plain-English summary of J Cosmet Dermatol 2023, PMID 36606378, DOI 10.1111/jocd.15589]. Magellan Longevity. https://magellanlongevity.com/study/s195.html
BibTeX
@misc{magellan_s195, title = {What are the various delivery methods of tranexamic acid (TXA) for treating melasma, and how effective are they compared to traditional treatments?}, author = {{Magellan Longevity}}, year = {2026}, howpublished = {\url{https://magellanlongevity.com/study/s195.html}}, note = {Plain-English summary of PubMed PMID 36606378; DOI 10.1111/jocd.15589; J Cosmet Dermatol 2023. Reviewed by Gabriel Radu, DO}, urldate = {2026-08-11} }
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How this summary was made. Every section above restates what the published abstract of PMID 36606378 reports — the question, the design, the numbers, the authors’ own conclusion and their stated limitations. We do not add claims the paper did not make, and we keep negative and no-effect findings in. Magellan’s evidence grades are set from research like this and never from affiliate commissions.

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Educational information, not medical advice. This is a plain-English summary of published research; it is not a treatment recommendation and nothing here is intended to diagnose, treat, cure, or prevent any disease. Individual studies can be wrong, and a single paper rarely settles a question. Talk to your physician before acting on any research, especially if you are pregnant, nursing, or taking medication.