Melasma is a common acquired disorder characterised by symmetric hyperpigmented patches with an irregular outline occurring most commonly on the face Although the exact pathogenesis is unknown melasma is thought to be caused by hyperfunction of the melanocytes in the skin following UV exposure leading to increased amounts of melanin Additionally hyperestrogenic states oral contraceptive pills medications like phenytoin phototoxic drugsnthyroid disease have a role in the pathogenesis of melasma It commonly involves the centrofacial region forehead cheeks nose upper lip sparing the philtrum and nasolabial folds chin malar region less commonly the mandibular region Based upon its location of the pigment it can be classified into epidermal dermal mixed or indeterminate Theoretically on Woods Lamp examination epidermal type enhances whereas dermal melanin becomes less obvious but this does not correlate on histopathology On dermoscopy melasma appears as light to dark brown globules with perifollicular sparing and the pigmentation pattern is reticular or pseudoreticular with diffuse dark brown to grey pigmentation involving the follicular openings 

As per Khuraiya et al  melasma has been treated with various treatment modalities most importantly sunscreen triple combination creams azelaic acid ascorbic acid kojic acid and arbutus chemical peels lasers but none might prove fully effective

Tranexamic Acid is a plasmin inhibitor and an antifibrinolytic which has potential as an emerging treatment modality for Melasma It has some anti inflammatory and hypopigmentary properties when used either systemically or topically TA inhibits plasminogen activator which helps in plasminogen to plasmin conversion It inhibits melanin synthesis by interfering with melanocyte keratinocyte interaction by inhibiting the plasmin system

According to Sarkar et al The use of tranexamic acid in melasma was an accidental discovery by Nijo et al in 1979 in a patient with urticaria Further the identification of the vascular component in melasma pathogenesis led to its rapid and widespread usage

Although oral Tranexamic Acid has been proven to be an effective treatment strategy in many studies evidence is required in the field of usage of intralesional TA in the treatment of Melasma