Objectives: Tranexamic acid is an antifibrinolytic indicated for severe bleeding with a dose between 2000 and 3000 mg. Tranexamic acid inhibits the transformation of plasminogen into plasmin. Plasmin promotes communication between the keratinocyte, melanocyte and fibroblast. In this class we will discuss the mechanism of action of tranexamic acid, its indications for the treatment of Melasma, the tests necessary for its prescription, possible side effects and monitoring conduct. Our goal is that after this class, the student can safely prescribe tranexamic acid for the treatment of Melasma. Introduction: Melasma is a very prevalent, chronic dyschromia, with multifactorial etiopathogenesis characterized by brownish spots, preferably on the face of young women with a high skin type. Its etiology is multifactorial with the involvement of genetics, hormones, ultraviolet radiation and inflammation. Its treatment is a challenge for the dermatologist. Tranexamic acid is an antifibrinolytic used to control intense bleeding that inhibits the transformation of plasminogen into plasmin. Plasmin promotes the release of leukotrienes, stimulates the endothelial growth factor VEGF, favors the action of tyros Materials / method: Studies are presented on the different actions of tranexamic acid for the treatment of Melasma. Furthermore, a meta-analysis was carried out at the University of Mogi das Cruzes with 32 studies of confirmed quality. Results: After evaluating these various studies, we reached the following results: Topical tranexamic acid can be used as an adjuvant in the treatment of Melasma. Its use has no side effects and helps with whitening. Systemic use is more effective when combined with hydroquinone than hydroquinone alone. The use of oral Tranexamic must be supported by a complete history and necessary exams to avoid use in patients at risk of thrombosis. Conclusion: The use of tranexamic acid in the treatment of Melasma is interesting to avoid provocative stimuli and can be used as an adjunct both at the beginning of treatment and for maintenance. More studies and scientifically based work are needed to establish definitive conclusions.

Disclosures - Denise STEINER

> Did you receive any funding to support your research for this TOPIC?
No

> Were you provided with any honoraria, payment, or other compensation for your work on this study?
No

> Do you have any financial relationship with any entity which may closely compete with the medications, materials, or instruments covered by your study?
No

> Do you own or have you applied for any patents in conjunction with the instruments, medications, or materials discussed in your study?
No

This work was not supported by any direct or indirect funding. It is under the author's own responsibility