Nagaraju D, et al. - In patients with refractory melasma, authors assessed the effectiveness of oral tranexamic acid (TXA), a plasmin inhibitor. In patients willing to undergo biopsy, they also compared the histopathological and immunohistochemical changes in pretreatment and post-treatment skin biopsies. Findings suggested a correlation of clinical improvement in melasma in a perfect linear relationship with quality of life, decrease in epidermal pigmentation, and decrease in Melan A staining on immunohistochemistry. They noted that TXA inhibits melanin synthesis and melanocyte proliferation.