Many studies have shown the use of tranexamic acid to be an effective and safe medication for the treatment of melasma. We talk to Dr Marisa Heyns, a general practitioner with her Masters in Aesthetic Medicine, about the role of tranexamic acid and how to incorporate it into treatment protocols.
Can you tell us more about the action of tranexamic acid on the skin?
Tranexamic acid works in 3 synergistic ways: it reduces excessive vascularisation which characterises recurrent hyperpigmentation, it inhibits the inflammatory processes caused by external aggressors that lead to the activation of melanogenesis, and it slows down the activity of tyrosinase, which further reduces the proliferation of melanocytes.
Is tranexamic acid safe?
One of the benefits of tranexamic acid is that is it well tolerated by the skin and has a high safety margin with little side effects. Since melasma cannot be cured, it needs to be continually managed, and tranexamic acid offers the benefit of safe use for an indefinite period of time
How do you recommend incorporating it into depigmentation protocols?
In clinic, I recommend combining a chemical peel with micro-needling: I use the mesopeel melanostop tran3x and c.prof depigmenting solution by mesoestetic, both containing tranexamic acid. I do the chemical peel and follow a micro-needling session directly after. 5 sessions at 2 week intervals give a great result. I highly recommend incorporating homecare products with the treatment plan: mesoestetic’s newly launched melan tran3x concentrate and melan tran3x gel cream are an innovative combination of 2 products which, used jointly, provide a continuous, gradual reduction of excess melanin, delivery very effective results.
Who is the ideal candidate?
Someone with modular pigmentation: solar and senile lentigos, ephelides and various grades of PIH. Pigmentation in body areas, such as friction areas, armpits and inner thigh can also be treated. It’s a great option post-laser in order to prevent rebound PIH (common among medium and dark phototypes) and to improve and enhance depigmenting outcomes. It is also recommended as a maintenance treatment for the popular cosmelan® and dermamelan® depigmentation methods in order to keep pigmentation under control once the initial 12 month method is completed.