Pigmentations such as melasma are extremely common, particularly in regions with year-round sun exposure like Singapore. For many of us, melasma can be especially frustrating because it often appears gradually, becomes more noticeable over time, and may recur despite consistent skincare and is difficult to treat.
Melasma typically presents as uneven brown or grey-brown patches across the cheeks, forehead, or upper lip. While medically harmless, its visible nature can affect confidence and may be challenging to manage because it is influenced by multiple internal and external factors rather than a single cause.
At Lynn Medical, we approach pigmentation concerns with the understanding that melasma is not simply a surface issue. Modern dermatology increasingly recognises that persistent pigmentation involves deeper cellular signalling pathways, inflammation, vascular influences, and hormonal triggers. This has led to growing clinical interest in ingredients such as tranexamic acid, which has been studied for its role in supporting melasma improvement as part of a structured medical plan.
Understanding Tranexamic Acid: Where It Comes From
Tranexamic acid, often abbreviated as TXA, is a synthetic derivative of the amino acid lysine. It was first developed in the mid-20th century and has long been used in medicine to reduce excessive bleeding by inhibiting a process known as fibrinolysis.
Interestingly, researchers later observed that the same biological pathway involved in clot regulation may also influence pigment activation within the skin. This discovery opened new possibilities in dermatologic and aesthetic applications, particularly for conditions such as melasma.
Why Melasma Can Be So Persistent
Melasma develops when pigment-producing cells known as melanocytes become overactive, leading to excess melanin deposition in the skin. This overactivity may be triggered or worsened by ultraviolet exposure, hormonal fluctuations, genetics, or chronic skin inflammation.
Unlike freckles and sun spots, melasma is often more complex. This is because it involves stimulation from surrounding skin cells and inflammatory mediators. This is one reason why melasma frequently requires an effectively customised treatment modality rather than a single treatment approach.
How Tranexamic Acid May Support Pigmentation Improvement
Tranexamic acid inhibits the activation of plasmin, which may reduce these downstream pigment signals and help moderate melanocyte stimulation over time.
In a 2019 clinical study of 100 patients to find out the benefits of 2 variations of treatment for melasma, namely, tranexamic acid and hydroquinone. By the end of 12 weeks, the appearance of melasma in the group using tranexamic acid had improved by 27%, comparable to that in the group using hydroquinone. However, the clinical study also revealed that higher satisfaction rate was noted in the group using tranexamic acid as the rate of side effects such as skin irritation was low.
Rather than functioning as a simple bleaching agent, TXA is better understood as a pigment-modulating ingredient that influences the biological environment contributing to melasma.
Different Forms of Tranexamic Acid in Melasma Treatment
In aesthetic dermatology today, tranexamic acid has been explored in several different formats depending on the individual’s skin profile and the severity of pigmentation.
Oral tranexamic acid, where the ingredient is taken in tablet form under medical supervision, is one of the approach in treating pigmentation. Oral tranexamic acid allows TXA to work systemically by influencing pigment activation pathways throughout the skin. Oral TXA has been widely studied in melasma care, and a meta-analysis published in the American Journal of Clinical Dermatology reported clinically significant improvements in melasma severity scores in many patients when used as part of combination management. At the same time, systemic use requires careful medical screening, as it may not be suitable for individuals with certain clotting-related risk factors.
Tranexamic acid is also commonly formulated into topical skincare products such as brightening serums or pigment-support creams. In this form, it is applied directly to the skin and may help reduce local pigment signalling while supporting overall tone clarity. Topical TXA is often considered for mild pigmentation concerns or as an adjunct alongside other medical-grade ingredients, particularly because melasma frequently requires long-term maintenance rather than a single intervention.
Another method that has gained attention in recent years is intradermal tranexamic acid, where small, controlled amounts are delivered into targeted areas within the skin. This localised approach places the ingredient closer to pigment-producing cells and may offer more direct modulation of melasma pathways in selected individuals. A systematic review published in the Journal of Cosmetic Dermatology highlighted that intradermal TXA has shown promising clinical outcomes in improving melasma indices, although ongoing research continues to refine protocols and evaluate long-term recurrence patterns.
The Importance of a Long-Term, Multi-Modalities Approach
It is important to recognise that melasma is rarely managed through one method alone. In Lynn Medical, we stand by our multi-pronged approach that includes strict sun protection, appropriate topical care, and prescribed medical treatments over time.
Even when pigmentation appears lighter, UV exposure remains one of the strongest triggers for recurrence, making broad-spectrum sunscreen and long-term photoprotection essential components of any melasma plan.
What Tranexamic Acid Can and Cannot Do
Tranexamic acid represents one of the more researched medical ingredients in modern pigmentation care, particularly because it targets deeper signalling mechanisms rather than surface pigment alone.
However, results may vary between individuals. Realistically, no single treatment can promise complete or permanent removal of melasma. The role of TXA is used as part of an evidence-based treatment approach to support improvement in the appearnace of melasma. With ongoing maintenance, it helps to enhance our skin natural resilience.
Personalised Pigmentation Treatment at Lynn Medical
At Lynn Medical, every pigmentation concern is assessed individually, with treatment recommendations guided by clinical evidence, safety considerations, and each patient’s skin biology.
If you are experiencing persistent melasma or uneven skin tone, a personalised consultation can help determine whether tranexamic acid-based approaches may be appropriate within your broader pigmentation care journey.
References
Melasma: Etiologic and therapeutic considerations — Grimes PE (Archives of Dermatology)
https://pubmed.ncbi.nlm.nih.gov/7492140/Tranexamic Acid for Adults with Melasma: A Systematic Review and Meta-Analysis — Zhang L et al. (Biomed Research International)
https://pmc.ncbi.nlm.nih.gov/articles/PMC6247725/Intradermal Injection of Tranexamic Acid for the Treatment of Adult Melasma: A Systematic Review and Meta-Analysis — Chen LY et al. (Facial Plastic Surgery & Aesthetic Medicine, 2025)
https://pubmed.ncbi.nlm.nih.gov/39574359/Comparative Efficacy and Safety of Tranexamic Acid for Melasma (Network Meta-Analysis) — Rongzhou Liang et al. (J Cosmet Dermatol, 2024)
https://pubmed.ncbi.nlm.nih.gov/38059683/
