In a study by Zhang et al., who investigated the effect of platelet-rich plasma (PRP) combined with tranexamic acid (TXA) in the treatment of melasma and its effect on the serum levels of vascular endothelial growth factor (VEGF), endothelin-1 (ET-1), and melanin-stimulating hormone (MSH), they reported that PRP combined with TXA can improve the treatment outcome, maintaining normal levels of VEGF, ET-1 and MSH, and reducing the recurrence rate [22]. This evidence concerns the gene VEGFA and freckles.