--- title: "Evidence: inhibits plasmin, reduces melanin" description: "Tranexamic acid effectively treats melasma through various delivery methods, with oral TXA being most potent but having side effects, and topical TXA…" url: "https://magellanlongevity.com/study/s195.md" canonical: "https://magellanlongevity.com/study/s195.html" html: "https://magellanlongevity.com/study/s195.html" type: "study" study_key: "s195" journal: "J Cosmet Dermatol" year: 2023 pmid: "36606378" doi: "10.1111/jocd.15589" citations: 1 updated: 2026-09-02 author: "Gabriel Radu, DO" author_credentials: "Physiatrist (PM&R). NY medical license 275110. NPI 1376861765." publisher: "Magellan Longevity" content_format: "markdown" --- # Evidence: inhibits plasmin, reduces melanin [Home](https://magellanlongevity.com/) › [Research map](https://magellanlongevity.com/longevity-research-map.html) › Evidence: inhibits plasmin, reduces melanin **HTML version:** https://magellanlongevity.com/study/s195.html · **In the Magellan app:** https://magellanlongevity.com/#/study/s195 ## Citation | Field | Value | | --- | --- | | Journal | J Cosmet Dermatol | | Year | 2023 | | PMID | [36606378](https://pubmed.ncbi.nlm.nih.gov/36606378/) | | DOI | [10.1111/jocd.15589](https://doi.org/10.1111/jocd.15589) | | Study key | s195 | ## 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? ## Hypothesis The study aims to characterize the efficacy of different TXA delivery methods for melasma treatment. ## Methods 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. ## Results 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. ## Conclusion 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. ## Verbatim from the abstract > topical tranexamic acid can improve outcomes and is better tolerated than hydroquinone ## Where this study is used on Magellan This paper is one of the citations behind the evidence grade on the pages below. Grades are assigned from the published research and are independent of affiliate commissions. | Compound or device | Evidence grade | Graded pages | | --- | --- | --- | | Topical Tranexamic Acid Serum | Moderate evidence | [Topical Tranexamic Acid Serum](https://magellanlongevity.com/p/195.md) | ## Reference 1. **Evidence: inhibits plasmin, reduces melanin** J Cosmet Dermatol 2023 · [PMID 36606378](https://pubmed.ncbi.nlm.nih.gov/36606378/) · [DOI 10.1111/jocd.15589](https://doi.org/10.1111/jocd.15589) > topical tranexamic acid can improve outcomes and is better tolerated than hydroquinone ## Structured data ```json {"@context":"https://schema.org","@graph":[{"@type":"MedicalWebPage","@id":"https://magellanlongevity.com/study/s195.html#page","url":"https://magellanlongevity.com/study/s195.html","name":"Evidence: inhibits plasmin, reduces melanin","description":"Tranexamic acid effectively treats melasma through various delivery methods, with oral TXA being most potent but having side effects, and topical TXA…","inLanguage":"en","isPartOf":{"@type":"WebSite","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"author":{"@type":"Person","name":"Gabriel Radu, DO","jobTitle":"Physiatrist (PM&R)","identifier":[{"@type":"PropertyValue","name":"NPI","value":"1376861765"},{"@type":"PropertyValue","name":"NY medical license","value":"275110"}]},"publisher":{"@type":"Organization","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"encoding":{"@type":"MediaObject","encodingFormat":"text/markdown","contentUrl":"https://magellanlongevity.com/study/s195.md"},"dateModified":"2026-09-02"},{"@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://magellanlongevity.com/"},{"@type":"ListItem","position":2,"name":"Research map","item":"https://magellanlongevity.com/longevity-research-map.html"},{"@type":"ListItem","position":3,"name":"Evidence: inhibits plasmin, reduces melanin","item":"https://magellanlongevity.com/study/s195.html"}]},{"@type":"ScholarlyArticle","@id":"https://magellanlongevity.com/study/s195.html#study","name":"Evidence: inhibits plasmin, reduces melanin","headline":"Evidence: inhibits plasmin, reduces melanin","datePublished":"2023","isPartOf":{"@type":"Periodical","name":"J Cosmet Dermatol"},"identifier":"PMID:36606378","url":"https://pubmed.ncbi.nlm.nih.gov/36606378/","sameAs":"https://doi.org/10.1111/jocd.15589","abstract":"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."}]} ``` ## Related on Magellan Longevity - [Topical Tranexamic Acid Serum](https://magellanlongevity.com/p/195.md) — product graded on this and related evidence - [Comparative efficacy and safety of tranexamic acid for melasma by different…](https://magellanlongevity.com/study/d38059683.md) - [Effectiveness of laser and topical tranexamic acid combination therapy in melasma: a…](https://magellanlongevity.com/study/d37326860.md) - [Longevity research map](https://magellanlongevity.com/longevity-research-map.html) - [Evidence-based longevity supplements](https://magellanlongevity.com/longevity-supplements.md) ## Scope and disclosures Educational information, not medical advice. Nothing here is intended to diagnose, treat, cure, or prevent any disease. Talk to your physician before starting any supplement or device, especially if you are pregnant, nursing, or taking medication. Editorial firewall: evidence grades are assigned from the published research and are independent of any affiliate commission. As an Amazon Associate, Magellan Longevity earns from qualifying purchases. Reviewed for accuracy by a board-certified physician (DO).