{
  "id": "tranexamic-acid-topical",
  "idVersion": 1,
  "ingredient": "Tranexamic Acid",
  "route": "topical",
  "grade": "limited",
  "gradeLabel": "Limited",
  "claim": "One small vehicle-controlled trial found 5% topical tranexamic acid no better than its vehicle after 12 weeks and reported more redness.",
  "caveat": "The dedicated topical trial enrolled 23 women and 21 completed. A 22-trial review mixed topical, injected, and oral routes and had high heterogeneity. A separate 99-person study compared tranexamic-acid and niacinamide combination creams with 4% hydroquinone, so it did not isolate tranexamic acid or prove the formulas equivalent.",
  "published": "2026-09-19",
  "sources": [
    {
      "url": "https://pubmed.ncbi.nlm.nih.gov/22506692/",
      "journal": "J Cosmet Laser Ther",
      "year": 2012,
      "n": 23,
      "design": "Double-blind split-face trial",
      "duration": "12 weeks",
      "percentages": [
        "5%"
      ],
      "outcome": "melanin index, melasma severity, erythema",
      "finding": "Double-blind 12-week split-face trial: 23 women enrolled and 21 completed. The 5% tranexamic acid side was neither superior nor different from vehicle for pigmentation, while erythema was significantly higher on the tranexamic-acid side.",
      "formulation": "5% topical tranexamic acid gel, vehicle gel"
    },
    {
      "url": "https://pubmed.ncbi.nlm.nih.gov/38843906/",
      "journal": "J Dermatolog Treat",
      "year": 2024,
      "n": 1280,
      "design": "Systematic review and meta-analysis of 22 randomized trials",
      "duration": null,
      "percentages": [],
      "outcome": "melasma severity, adverse effects",
      "finding": "Systematic review and meta-analysis of 22 randomised trials with 1,280 patients. Oral treatment showed the largest pooled MASI decrease, followed by injections and topical applications; studies had high heterogeneity, especially among combination treatments.",
      "formulation": "oral tranexamic acid, injected tranexamic acid, topical tranexamic acid"
    },
    {
      "url": "https://pubmed.ncbi.nlm.nih.gov/41315336/",
      "journal": "Sci Rep",
      "year": 2025,
      "n": 99,
      "design": "Randomized double-blind active-comparator trial",
      "duration": null,
      "percentages": [
        "4%"
      ],
      "outcome": "melanin index, melasma severity, quality of life, adverse reactions, relapse",
      "finding": "Randomised double-blind 99-person comparison of two tranexamic-acid and niacinamide combination creams with 4% hydroquinone. Because neither test cream isolated tranexamic acid and the comparator was active, the trial does not establish tranexamic acid alone or prove equivalence.",
      "formulation": "2% tranexamic acid with 2% niacinamide niosomal cream, 5% tranexamic acid with 4% niacinamide conventional cream, 4% hydroquinone cream"
    }
  ],
  "peopleReport": null
}