Tranexamic Acid vs Hydroquinone for Melasma: Complete Comparison Guide

Tranexamic acid and hydroquinone are the two most-studied prescription agents for melasma — tranexamic acid works through anti-plasmin and anti-angiogenic pathways, while hydroquinone directly inhibits tyrosinase to block new melanin production.

Hydroquinone Mechanism and Limits

Hydroquinone at 2-4 percent inhibits tyrosinase, reducing pigmentation within 8-12 weeks. Long-term continuous use beyond 6-12 months risks exogenous ochronosis. Korean dermatologists typically use pulsed dosing with rest periods.

Tranexamic Acid Routes and Safety

Oral tranexamic acid 250mg twice daily for 8-12 weeks shows efficacy with thromboembolic screening. Topical 2-5 percent provides milder safer effect. Microinjection delivery is favored in Korean clinics.

FAQ

Can I use both tranexamic acid and hydroquinone at the same time?

Yes. Many Korean dermatology protocols layer topical tranexamic acid with pulsed hydroquinone under physician guidance.

Sources

Sources: Korean Dermatological Association, PubMed, KHIDI.

Last medically reviewed: 2026-05-23. General educational information for international patients, not medical advice. Consult a board-certified physician.