The top choice for difficult-to-treat skin conditions is the dermatologist. According to a board-certified dermatologist, it manifests as blotchy, darkened patches on the skin. This means that anything, from sunlight to hot yoga classes to genetics, could trigger your melasma flare-up.

So, while we haven’t found a cure for melasma just yet, it still can be treated, says founder of Skin Wellness Dermatology in Birmingham, Alabama. Topical treatments like cysteamine and azelaic acids are the most common form of melasma treatment. Or, you can layer in-office treatments like a laser or chemical peel. If you have more severe cases of melasma or have deeper skin, these treatments may not have made any difference.

Don’t lose out on all hope just yet; there’s a new acid on the block that might help in treating melasma. We speak with medical experts to find out what tranexamic is and how it works.

What Exactly Is Tranexamic Acid?

Dr. Hartman says Lysteda is often prescribed to women who have heavy periods in order to decrease blood flow. Doctors noticed a positive side effect: patients taking Lysteda were reporting significant improvements in their melasma.

How Does It Work?

Dr. Yadav explained that tranexamic acids inhibit tyrosinase (the pigment-producing process in melanocytes). Dr. Hartman adds that it also blocks the transfer pigment from melanocytes to the skin’s outermost layers.

Some says that tranexamic acid can also decrease the number of blood vessels in your skin. What does this all have to do with melanomas? Hyperpigmentation, a pesky form, increases blood vessel count, which in turn revives up pigment-producing cells. Tranexamic acid reduces pigment production by lowering blood vessel count. It’s important to remember that more research is needed before there can be a scientific consensus.

Are There Any Side Effects?

Oral tranexamic acids can trigger blood clot formation. Dr. Yadav says that tranexamic is being prescribed off-label. It has not been approved by the FDA for melasma. It is important to consult your doctor to assess if oral tranexamic acid is safe for you.

If you’ve dealt with blood clots in the past or if you’re predisposed to them, Dr. Idriss advises against taking tranexamic acid orally and suggests that you use it as a topical treatment instead. On extra-bright days, she recommends wearing sunscreen and an oversized hat. Dr. Yadav says it’s best to avoid excessively hot conditions. It’s like spending hours in the sauna or hiking on hot days.