By way of topicals, “hydroquinone has lengthy been the gold customary for lightening melasma,” says Sandra Lee, MD, a board-certified dermatologist and founding father of SLMD Skincare. Primarily, hydroquinone decreases the manufacturing of melanin by inhibiting a pigment-producing enzyme referred to as tyrosinase. Although there’s a protracted listing of do’s and don’t’s with regards to hydroquinone, when utilized correctly, it has been confirmed to lower the looks of hyperpigmentation. Different frequent components for treating melasma (a lot of which can be utilized together) embody retinoids, vitamin C, kojic acid, niacinamide, alpha hydroxy acids, beta hydroxy acids, azelaic acid, and arbutin.
Whereas these topicals have proven promise, by nature, many aren’t designed to deal with extra extreme melasma. “Many of the lotions in the marketplace goal the signs of melasma — the pigment within the pores and skin — by growing cell turnover, however not the first reason for the situation, that are the pores and skin cells that produce the pigment,” says Ariel Ostad, MD, a board-certified dermatologist in New York Metropolis. “Some topical merchandise like hydroquinone or azelaic acid can decelerate melanin manufacturing, however not as successfully or profoundly as oral tranexamic acid.” And oral is the important thing phrase right here: Although tranexamic acid can be utilized topically to sluggish melanin synthesis, medical research present it really works rather more successfully when taken in pill-form.
What’s oral tranexamic acid?
As Dr. Ostad mentioned, oral tranexamic acid (OTA) inhibits the manufacturing of melanin within the pores and skin. Like hydroquinone, that is achieved by interfering with the exercise of sure enzymes concerned in melanin synthesis, he says. (Although it has “acid” in its identify, OTA just isn’t an acid like glycolic or salicylic, says Dr. Frank: “Acid simply refers to the kind of chemical construction compound.”)
Although our focus right here is on the remedy of melasma, oral tranexamic acid can also be an FDA-approved anti-fibrinolytic agent, which means it inhibits the dissolution of blood clots, which in flip helps forestall heavy bleeding. “It may be used to assist deal with heavy menstrual bleeding in girls and will also be utilized in dental and coronary heart surgical procedure in sufferers with bleeding problems,” says Dr. Ostad.
“By way of treating melasma, oral tranexamic acid is a kind of ‘blissful accidents,’ like the invention that an eye fixed remedy referred to as Botox helps scale back wrinkles,” provides Dr. Lee. “Sufferers taking oral tranexamic acid [for other ailments] began reporting to their medical doctors that their melasma began bettering whereas taking the drug. This led to medical research, and now tranexamic acid is likely one of the instruments we will use to enhance this cussed situation.”