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Concomitant deficiencies (iron, folate), chronic illness, or drug interactions may blunt clinical response and warrant further evaluation

Their identity, strength, and quality may be uncertain

Its first usage in the treatment of melasma dates back to 1979.[] It has been reported to be efficacious as oral medication, localized intradermal microinjection[] or intravenous formulation (not available in India).[] Several mechanisms of action have been proposed for this medication, and those have been tabulated below [Table 2].[] Several authors have demonstrated the efficacy of oral TA in melasma [Table 3]

M., Shah, M., Shah, S., Li, A