Melasma, a chronic pigmentary skin condition mainly affecting the face, remains a challenge despite the availability of several options for treatment. Many melasma patients are not satisfied with treatment outcomes. Tranexamic acid (TXA), an anti‑fibrinolytic drug, has shown promising results in patients with melasma. Evidence from several clinical studies has surfaced on the efficacy and tolerability of TXA in these patients. It can be used as monotherapy or adjuvant with other therapies. Currently, there is no published consensus or guideline document for its use in the treatment of melasma. TXA is available for oral use, topical use, and injection. Therefore, a consensus of Indian experts is prepared based on the available literature and experience with the use of oral TXA in melasma (Table 1).

Reference: Godse K, Sarkar R, Mysore V, et al. Oral tranexamic acid for the treatment of melasma: Evidence and experience‑based consensus statement from Indian experts. Indian J Dermatol. 2023;68:178–185.