Can Oral Tranexamic Acid And Topical Retinols Be Combined?

Can Oral Tranexamic Acid And Topical Retinols Be Combined?

Tranexamic acid is a prescription-only drug taken orally or applied topically to treat melasma and other hyperpigmentation conditions. Oral tranexamic acid has shown great promise as a long-term melasma treatment that has few side effects. Combining treatments for melasma can be more effective at clearing dark patches of skin than a single treatment on its own. Today, we take a look at whether you can safely use oral tranexamic acid and topical retinols.

How does oral tranexamic acid work and what are its possible side effects?

Oral tranexamic acid treats hyperpigmentation by inhibiting the melanin production process. Melasma and hyperpigmentation show significant improvement after taking low doses of between 500mg and 1500mg per day for eight to twelve weeks.

Current research has not encountered any significant side effects of taking low doses of oral tranexamic acid for extended periods (Del Rosario). However, the risk of blood clotting disorders like embolisms remains (oral tranexamic acid also treats bleeding disorders), so it is vital to speak with a healthcare professional before starting use.

How do topical retinols work and what are possible side effects?

Retinol derives from retinoids/retinoic acid/vitamin A and treats various skin conditions. Topical retinol penetrates the outer skin layer (epidermis) through to the dermis. There, its tiny molecules neutralize free radicals and promote collagen and elastin production. The result is a fuller, plumper skin appearance that reduces the visibility of wrinkles, fine lines, and enlarged pores.

Retinol can treat:

  • Acne
  • Fine lines
  • Wrinkles
  • Sunspots
  • Freckles
  • Photoaging
  • Uneven skin texture
  • Melasma
  • Large pores

Unlike prescription-only retinoids, retinol is available in over-the-counter (OTC) formulations because it is relatively weaker than retinoids.

The primary side effects of topical retinol are skin dryness, irritation, redness, itching, and skin peeling. In addition, retinol can make the skin more sensitive to UV rays, heightening the risk of sunspots, post-inflammatory hyperpigmentation, and wrinkles.

Should you combine oral tranexamic acid and topical retinols?

As a rule of thumb, doctors do not recommend combining treatments yourself (self-medicating) as there might be factors overlooked that could make your melasma or hyperpigmentation worse.

Since oral tranexamic acid and retinol are both acids, they might have the same drying effect on the skin, increasing the risk of UV skin damage. Another factor that might affect using this combination treatment is the skin type and condition.

Safe And Effective Treatment For Hyperpigmentation With ClearifiRx

Before using oral tranexamic acid and topical retinol together, speak to a skincare professional like the board-certified dermatologists at ClearifiRX.
Our experts will evaluate your skin and overall health and tell you whether combining oral tranexamic acid and topical retinol will work for you. If this combination is unsuitable, they can recommend substituting one or both treatments for the safest, most effective results for your skin.


Brandon Kirsch

Brandon Kirsch, MD, FAAD, is a board-certified dermatologist specializing in clinical drug development and medical innovation. He is the founder of Kirsch Dermatology in Naples, Florida ( and is also the Chief of Dermatology at the Naples Community Hospital.

Dr. Kirsch started his career as a lawyer and holds law degrees from the University of Western Ontario (LL.B.) and Georgetown (LL.M. Securities and Financial Regulation). Dr. Kirsch completed his pre-medical studies at the University of Pennsylvania, medical school at Brown University, internship at the Mayo Clinic (Florida) and dermatology residency at the University of North Carolina. In partnership with the Mayo Clinic, he filed to patent a novel topical composition for the treatment of skin hyperpigmentation that he co-developed and also oversaw a successful pilot study of the formulation.

Dr. Kirsch has experience with therapeutic drug development programs from pre-clinical to Phase 3 studies. He is licensed to practice medicine in California, Colorado, Florida, and North Carolina and law in New York and Ontario.

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