Tranexamic acid (TA) has antiplasmin activity and has been shown to be effective against melasma when administered orally, for which it is considered a first-line pharmacotherapy. Several studies have shown that topical TA is also effective against melasma and skin hyperpigmentation caused by sun exposure and inflammation. When applied topically, TA acts on neutrophils and mast cells in the dermis and on the vascular system. It is unlikely that topical TA affects dermal neutrophils or mast cells, or the vascular system to form thrombi. Studies conducted to evaluate the effect of topical TA on the hyperpigmentation process show that the resulting skin «lighte-ning» mechanism involves the suppression of the production of cytokines and chemical mediators that stimulate melanin production via urokinase-type tissue plasminogen activator and dermal vascular-derived plasminogen, thereby suppressing the production of excess melanin and preventing hyperpigmentation. This article presents clinical experience with the use of topical TA-based drug «Careju» for the prevention and treatment of post-inflammatory hyperpigmentation, which has a pronounced therapeutic potential.

Keywords: melanogenesis, plasminogen, Careju, post-inflammatory hyperpigmentation, tranexamic acid