Tranexamic Acid or Azelaic Acid to Fight Discoloration? Or Both?

• Both azelaic acid and tranexamic acid help even skin tone and reduce discoloration by interfering with melanin production.
• Azelaic acid is a dicarboxylic acid with antioxidant and anti-inflammatory properties that also exfoliates the skin.
• Tranexamic acid is a monocarboxylic acid that also reduces UV-induced pigmentation and restores the protective barrier.
• Studies found that 3% tranexamic acid is as effective as 20% azelaic acid at brightening and fading hyperpigmentation.
• Tranexamic acid is more suitable for sensitive skin than azelaic acid.
• Azelaic acid and tranexamic acid are two ingredients that can be used together for more dramatic results.

If you’re weighing up the benefits of tranexamic acid vs. azelaic acid, it means you’re trying to even your skin tone and banish discoloration. These two ingredients both serve as the main selling pitch in skincare products targeting uneven tone and hyperpigmentation, yet they work differently. Azelaic acid and tranexamic acid are, in fact, two of the hottest skin brighteners out there, so it makes total sense to wonder which one is better. That’s why in today’s post, we put azelaic acid vs. tranexamic acid to fight and uncover the differences between the two. And the catchy part: can you use tranexamic acid and azelaic acid together?

Are you feeling intrigued yet?

What is azelaic acid?

Azelaic acid is a naturally occurring compound within the class of dicarboxylic acids with antibacterial, antioxidant, and anti-inflammatory benefits.^[1] Although azelaic acid is mainly used to address acne and redness, it can also diminish discoloration such as dark spots and melasma since it interferes with melanin production — the pigment that darkens the skin color. More precisely, azelaic acid brightens the skin by inhibiting tyrosinase activity, the enzyme responsible for the production of melanin.^[2]

What is tranexamic acid?

On the other hand, tranexamic acid is a synthetic derivative of lysine amino acid within the class of monocarboxylic acids that also hinders melanin synthesis.^[3] However, compared to azelaic acid, tranexamic acid does not decrease melanin levels by reducing the activity of tyrosinase but blocking the transfer of pigment to the skin’s surface.^[4] More than that, studies found that tranexamic acid also offsets UV damage and consolidates the protective barrier. So how is tranexamic acid different from azelaic acid?

Tranexamic acid vs azelaic acid

The main difference between tranexamic acid and azelaic acid is that azelaic acid lightens skin by inhibiting tyrosinase and reducing melanin production, while tranexamic acid blocks the transfer of melanin in cells. Besides, azelaic acid is a dicarboxylic acid that also exfoliates and scavenges free radicals. In contrast, tranexamic acid is a monocarboxylic acid that mitigates UV-induced pigmentation and improves the barrier.

Another key difference between the two is that tranexamic acid is gentler than azelaic acid. Even though azelaic acid is generally well-tolerated, it can cause irritation and redness in some since it breaks down the skin’s barrier. On the flip side, tranexamic acid is more friendly and suitable for problematic skin, actually restoring the protective barrier and not messing with it. Other than that, both ingredients have potent brightening effects that even out skin tone as well as fade hyperpigmentation and other blemishes such as dark spots and post-acne marks.^[2][4]

Which one is better?

There’s no clear-cut way to decide which one is better in the battle of tranexamic acid vs. azelaic acid. Only one study directly compared the two, revealing that a combination of oral and topical 3% tranexamic acid is significantly more effective than oral tranexamic acid with 20% azelaic acid for melasma.^[5] Another perspective is to look at the studies that have compared tranexamic acid and azelaic acid with hydroquinone. According to the results, 5% tranexamic acid is as effective as 3% hydroquinone, and 20% azelaic acid provides the same benefits as 2% hydroquinone. So again, tranexamic acid wins the battle.^[6][7]

The verdict? The brightening power of 3% tranexamic acid is as effective as 20% azelaic acid. However, it is worth noting that 20% azelaic acid is a strength used for in-office treatments, while 3% tranexamic acid can be found in OTC products. Hence, another bonus point for tranexamic acid.

Can you use tranexamic acid and azelaic acid together?

While tranexamic acid vs. azelaic acid remains a controversial duel, you can team them up to reap the best of both worlds. So yes, you can definitely use tranexamic acid and azelaic acid together to even your skin tone and fade hyperpigmentation, boosting each one power. You can either apply a product infused with both ingredients or use them at alternate times, the tranexamic acid serum in the morning and azelaic acid in your PM routine.

References

1. National Center for Biotechnology Information (2022). PubChem Compound Summary for CID 2266, Azelaic acid. Retrieved May 6, 2022, from https://pubchem.ncbi.nlm.nih.gov/compound/Azelaic-acid.
2. Schallreuter KU, Wood JW. A possible mechanism of action for azelaic acid in the human epidermis. Arch Dermatol Res. 1990;282(3):168-71. doi: 10.1007/BF00372617. PMID: 2114832.
3. National Center for Biotechnology Information (2022). PubChem Compound Summary for CID 5526, Tranexamic acid. Retrieved May 6, 2022, from https://pubchem.ncbi.nlm.nih.gov/compound/Tranexamic-acid.
4. Kazuhisa Maeda, Yasushi Tomita, Mechanism of the Inhibitory Effect of Tranexamic Acid on Melanogenesis in Cultured Human Melanocytes in the Presence of Keratinocyte-conditioned Medium, Journal of Health Science, 2007
5. Malik, Fahmida & Hanif, Malik & Mustafa, Ghulam. (2019). Combination of Oral Tranexamic Acid with Topical 3% Tranexamic Acid versus Oral Tranexamic Acid with Topical 20% Azelaic Acid in the Treatment of Melasma. Journal of the College of Physicians and Surgeons–Pakistan : JCPSP. 29. 502-504. 10.29271/jcpsp.2019.06.502.
6. Janney MS, Subramaniyan R, Dabas R, Lal S, Das NM, Godara SK. A Randomized Controlled Study Comparing the Efficacy of Topical 5% Tranexamic Acid Solution versus 3% Hydroquinone Cream in Melasma. J Cutan Aesthet Surg. 2019 Jan-Mar;12(1):63-67. doi: 10.4103/JCAS.JCAS_40_18. PMID: 31057273; PMCID: PMC6484568.
7. Verallo-Rowell VM, Verallo V, Graupe K, Lopez-Villafuerte L, Garcia-Lopez M. Double-blind comparison of azelaic acid and hydroquinone in the treatment of melasma. Acta Derm Venereol Suppl (Stockh). 1989;143:58-61. doi: 10.2340/000155551435861. PMID: 2528260.