Tranexamic acid
Tranexamic acid: a 2026 global consensus lists topical use for acne marks and melasma; the two small 5% trials had no placebo group.
What it is
Tranexamic acid is a medicine best known for reducing bleeding. Researchers have tested it on the skin for dark pigmentation because it may also limit pigment production (Heidary 2025). Both trials cited below used it at 5% on the skin.
Evidence grades by concern
| Concern | Grade | Citations |
|---|---|---|
| Post-inflammatory hyperpigmentation | B | Sobhan 2023, Passeron 2026 |
| Melasma | B | Heidary 2025, Passeron 2026 |
Grade A: strong guideline recommendations or Korean MFDS notified actives. B: randomized controlled trials or systematic reviews. C: mechanism, small or uncontrolled studies.
What the evidence shows
Post-inflammatory hyperpigmentationB
In a 12-week single-blind randomized trial in people with acne, a 5% tranexamic acid solution and a 20% azelaic acid cream, each applied twice a day, both reduced the dark marks left by pimples (post-inflammatory hyperpigmentation), and the two did not differ significantly; 30 people in each group finished (Sobhan 2023). Side effects were less frequent with tranexamic acid in the first month. There was no placebo group, so the trial shows tranexamic acid performed similarly to azelaic acid, not that it works better than no treatment. The 2026 global consensus on hyperpigmentation lists tranexamic acid among topical options for post-inflammatory hyperpigmentation; it does not grade the strength of its recommendations (Passeron 2026).
MelasmaB
In a 12-week randomized trial of 50 women with melasma, a 5% tranexamic acid cream applied twice a day lowered melasma severity scores by about 51%, and tranexamic acid tablets lowered them by about 59%; the difference between the two was not significant (Heidary 2025). One person stopped the cream because of skin sensitivity. Both groups received tranexamic acid, so the trial did not compare the cream with no treatment, and it was run at a single centre. The 2026 global consensus lists topical tranexamic acid among first-line options for mild melasma and for maintenance (Passeron 2026).
What it does not do
Neither trial compared tranexamic acid with a placebo or with no treatment, so we cannot say how much of the improvement came from the ingredient itself. Both trials tested 5%; they do not show how lower amounts in cosmetics perform. Our evidence file has no trial of tranexamic acid for sun spots and freckles, for acne itself, or for redness.
Safety
- CIR status: not reviewed.
Products in our catalog
- Anua - Niacinamide 10% + TXA 4% Dark Spot Removing Serum
- celimax - Tranexamic Acid Brightening Cream Wrapping Mask
- celimax - Tranexamic Acid Spot Cream
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References
- Sobhan M, Talebi-Ghane E, Poostiyan E. A comparative study of 20% azelaic acid cream versus 5% tranexamic acid solution for the treatment of postinflammatory hyperpigmentation in patients with acne vulgaris: A single-blinded randomized clinical trial. J Res Med Sci. 2023;28:18.
- Passeron T, et al. Global consensus on the management of melanin hyperpigmentation disorders. J Eur Acad Dermatol Venereol. 2026;40(5):760-772.
- Heidary B, Meibodi GAH, Ardakani ME, Ramezani V, Heidari F. Randomized Clinical Trial on the Efficacy of Oral Tranexamic Acid Versus Topical Tranexamic Acid in Treatment of Melasma. J Cosmet Dermatol. 2025;24(9):e70428.