Tranexamic acid showed promise for treating melasma (dark patches on skin), especially when taken systemically, but it came with concerning side effects. Topical treatments alone—including tranexamic acid, hydroquinone, lasers, and peels—all had high recurrence rates. The best results came from combining 2-3 treatments together rather than using any single approach.

This was a systematic review that looked at existing melasma treatment research to compare what actually works. The researchers evaluated everything from topical creams to lasers to oral medications across multiple studies.

Funding not disclosed in abstract