Tranexamic acid

Question

I was prescribed tranexamic acid about six months ago for my stubborn melasma. My dermatologist said it’s one of the best treatments for pigmentation, and for a while, it seemed to be working. The dark patches on my cheeks and forehead started to lighten, and I felt hopeful. But as soon as I stopped taking it, the pigmentation came right back. Now I feel like I’m stuck in a cycle where I have to keep taking this medicine just to maintain the results, and honestly, that worries me.

I’ve also been feeling some weird side effects. Sometimes I feel lightheaded or nauseous after taking the pills, and I noticed that my periods have become slightly irregular since I started the medication. I looked it up, and I saw that tranexamic acid can increase the risk of blood clots, which freaks me out. My doctor said it's rare, but I don’t want to take chances with my health just for the sake of clear skin.

That’s why I’m looking into Ayurveda now. I’ve heard that melasma is often linked to internal imbalances, like liver health or excess heat in the body. I’d rather fix the root cause instead of just taking pills to suppress it. Does Ayurveda have any real treatments for melasma that actually work long-term? Are there specific herbs, oils, or dietary changes that can help lighten pigmentation naturally? I’ve read about manjistha, turmeric, and sandalwood being good for the skin, but how do I use them correctly?

I also want to know if stress or hormonal issues could be making my melasma worse. I work long hours, and I don’t always eat on time, so I wonder if that’s part of the problem. If anyone has treated melasma successfully with Ayurveda, please let me know what worked!

Dr Sujal Patil · Accepted Answer

Melasma in Ayurveda is linked to Pitta and Vata imbalance, often aggravated by stress, poor digestion, and heat accumulation in the liver. Tranexamic acid only suppresses symptoms, but Ayurveda focuses on detoxifying the liver, balancing hormones, and cooling excess heat for long-term results. Since your pigmentation returned after stopping the medicine, your body likely needs deeper healing. Manjistha (blood purifier), Neem (detoxifier), and Triphala (gut health) can help clear pigmentation from within. Drinking aloe vera juice or coriander juice in the morning also reduces Pitta-related skin issues.

For external treatment, mix Manjistha powder, turmeric, and sandalwood with rose water and apply as a face pack. Licorice root (Mulethi) is excellent for brightening pigmentation—apply Mulethi powder with milk or honey. Using Kumkumadi oil at night can also gradually fade dark patches. Since melasma is often worsened by hormonal imbalances, focus on Ashwagandha or Shatavari if stress or irregular periods are a concern. Avoid spicy, fried, and overly salty foods, as they increase Pitta and worsen pigmentation.

Your stress and irregular eating habits could be fueling melasma. Try mindful eating, regular meal timings, and cooling foods like coconut water, cucumber, and soaked almonds. If digestion is weak, Triphala at night can help. Ayurveda works gradually but permanently—with the right internal and external care, you can lighten melasma naturally without depending on medication!

Dr. Harsha Joy · Answer

Melasma in Ayurveda is linked to excess Pitta and toxin (Ama) accumulation, often aggravated by hormonal imbalances, liver dysfunction, stress, and poor digestion. Instead of suppressing symptoms like tranexamic acid, Ayurveda focuses on purifying the blood and balancing Pitta for long-term healing. Manjistha is excellent for detoxifying the blood and reducing pigmentation, while turmeric helps brighten the skin and balance inflammation. You can take these herbs internally as capsules or decoctions and apply them externally as a face pack with sandalwood and rosewater. A diet rich in cooling, hydrating foods like coconut water, coriander juice, and bitter greens can prevent excess Pitta buildup. Avoid spicy, fried, and processed foods, as they trigger pigmentation. Since stress and irregular eating patterns contribute to hormonal imbalance, practicing mindfulness, yoga, and proper mealtime discipline can significantly help. Liver-supporting herbs like Bhumiamalaki and Triphala can also improve detoxification and skin clarity. Ayurvedic treatments like Virechana (purgation therapy) may be beneficial for stubborn melasma by removing deep-seated toxins.

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