It started with a Japanese doctor and sexism…
Byrdie called it “new” and “noteworthy.” Cosmopolitan deemed it “the latest obsession among skincare experts.” InStyle said it’s “having a moment.” While tranexamic acid is a buzzy ingredient that’s now beloved for its ability to fade dark spots, discolorations, acne scars, splotchy complexions, and melasma — it’s hardly new.
Its skincare benefits were discovered accidentally in 1979, after a patient who was orally taking tranexamic acid (it helps treat or stop excessive blood loss) experienced the side effect of lightening of skin discoloration. The acid itself was discovered in the early 1960s, by a Japanese female medical doctor, Dr. Utako Okamoto, alongside her husband, Dr. Shoshuke Okamoto, in hopes of saving mothers from dying after childbirth from postpartum bleeding, a leading cause of maternal death in Japan at the time.
Though the ingredient is lauded today, the history of tranexamic acid is shrouded in sexism.
What Is Tranexamic Acid?
A synthetic derivative of the amino acid lysine, tranexamic acid (TXA) is known as an antifibriolytic medication which “stabilizes and preserves blood clots to help stop bleeding from major trauma or injuries, after giving birth, with some surgeries, nosebleeds, or heavy periods,” says dermatologist Dr. Amelia Hausauer in Cosmopolitan.
Originally taken orally, the research duo found it was twenty-seven times more powerful than a lysine-based drug. They published their findings in the Keio Journal of Medicine in 1962. Only Dr. Okamoto couldn’t find obstetricians to clinically trail her drug on postpartum women.
The Sexist History of Tranexamic Acid
Dr. Okamoto’s history-making research was overshadowed by sexism in the male-dominated medical research field. Early in her career, Dr. Utako was once asked to leave a conference on the grounds that medical conferences were not for women and children. When she first presented her research, she was ridiculed and asked if she was “going to dance” for the men in attendance. She worked longer hours than her male counterparts (10 hours to their 8) and had to bring her daughter to work because there wasn’t any childcare available.
The world didn’t realize the life-saving importance of tranexamic acid until decades later, when a British researcher named Ian Roberts explored the effect of tranexamic acid on cardiac surgery. He reached out to the Okamotos and filmed an interview with Dr. Utako about her work.
In 2010, a clinical study on postpartum hemorrhaging finally began. Dr. Okamoto sadly passed away one year before it concluded in 2016. Though she never learned the results of the study — which found it significantly reduces the chances of death from postpartum hemorrhaging, which kills about 100,000 women every year mainly in low-income and middle-income countries — she was resolute about her own findings. “I am absolutely sure that it’s going to be effective – I don’t need the research to know this.”
Tranexamic Acid in Skincare
Today tranexamic acid is used in everything from serums to peels to masks. Its effectiveness on skin was realized by happenstance, after a patient using the medicine off-label noticed the lightening of skin discoloration. When used topically (or taken orally), tranexamic acid decreases melanin production by inhibiting melanocytes, the pigment-making cells responsible for hyperpigmentation and melasma.
Tranexamic Acid Benefits
Tranexamic acid lightens and brightens skins by inhibiting irregular melanin production. It’s lauded for its ability to fade existing dark spots, acne scars and marks, and new melasma, in addition to preventing new discoloration from forming. It’s often mixed with vitamin C, niacinamide, or kojic acid to boost its brightening effects. It can work as soon as four weeks when used topically or taken orally regularly. Though it’s recommended to use for a full twelve weeks.
Despite its success story in skincare, tranexamic acid’s true history is steeped in a theme women of color know all too well: discrimination. Dr. Okamoto encountered and ultimately overcame incredible obstacles in a male-dominated society and field. Her story deserves to be told far and wide, and her name deserves to be synonymous with the ingredient which she first discovered and we apply with regularity on our faces today.
Read more about women of color changing history in this essay on the enduring appeal of activist Yuri Kochiyama.
