Tranexamic acid in the treatment of melasma

Abstract

Melasma is an acquired hyperchromia characterized by asymmetrical, brown-colored spots, preferably located in photo-exposed regions, such as the face, and other areas, such as the neck, chest, and forearms. The  disorder affects men and women of intermediate phototypes, with an  average age of 30 to 55 years, although it mainly affects women. Its  etiology is still not fully understood, but it is known that there are several  factors involved in its formation, such as genetic influences, exposure to ultraviolet radiation, pregnancy, hormonal therapies, cosmetics,  phototoxic drugs, endocrinopathies, emotional factors, and anticonvulsant medications. There are several treatments available for melasma, and for the present article, the cosmetic active tranexamic acid (ATX), a hydrophilic drug with a molecular weight of 157.2 g/mol, found in the form of a white crystalline powder that contains 99% to 100% of the active ingredient,was selected. This article is a descriptive and qualitative literature review and aims to analyze the potential use of the active ATX in the treatment of melasma. The results showed that ATX exerts its mechanism of antifibrinolytic, anti-hemorrhagic, and depigmenting actions through its reversible binding to lysine sites in the plasminogen molecule, inhibiting plasminogen activator, thus being considered a safe bleaching agent with good results. effective in the treatment of melasma and with low side effects. In this way, it is concluded that ATX proved to be an effective and safe compound for treating melasma, compared to other depigmenting actives, being well tolerated and with minimal adverse effects.