Hyperpigmentation is darkening of the skin from excess melanin, arising from sun exposure, inflammation, or hormonal change.
What randomized trials and meta-analyses show about tranexamic acid for melasma, including efficacy by route (oral, topical, injected), safety, and who should avoid it.
How clinicians tell melasma, post-inflammatory hyperpigmentation, and solar lentigines apart, why it changes treatment and prognosis, and the evidence-based options for each.
Evidence for FDA-approved hydroquinone + tretinoin + fluocinolone for melasma — efficacy vs monotherapy, adverse effects, and adjunctive options.