Background & Methods: The aim of the study is to compare the effect of combination of oral Tranexamic acid with modified Kligman regimen and modified Kligman regimen alone in the treatment of melisma. All the patients with melasma, satisfying the inclusion criteria were enrolled and written consent was obtained from them. Detailed history regarding sociodemographic data such as name, age, sex, address etc. was obtained and entered and proforma. Date of admission was noted along with detailed history regarding presenting complaints, past history, drug history, family history, personal history.

Results: Erythema was the only adverse effect observed in 4.7% cases in group 1 whereas in group 2, erythema, hypomenorrhea and burning were the adverse effects noted in 7.1%, 4.7% and 1.2% cases respectively. Although adverse effects were observed in higher proportions of cases in group 2 (12.9%) as compared to group 1 (4.7%), the observed difference was statistically insignificant (p>0.05).

Conclusion: Based upon the findings of present study, it could be concluded that modified Kligman regimen with or without oral tranexamic acid is effective in reducing the severity of melasma after 4 weeks of treatment. However, addition of oral Tranexamic acid to modified Kligman regimen resulted in faster therapeutic effect as compared to modified Kligman regimen alone after 8 weeks of treatment.