Tranexamic acid tablets are now commonly used in dermatology for the treatment of melasma, but at present, it mainly belongs to the category of empirical treatment, and needs to be applied under the guidance of doctors. The mechanism of tranexamic acid in the treatment of melasma is mainly that tranexamic acid tablets can reduce the activity of tyrosinase, thus inhibiting the formation of melanin, while tranexamic acid can also inhibit fibrinolytic enzyme, eliminate skin inflammation and vasodilatation, thus lightening melasma. According to the observation of clinical application, tranexamic acid tablets have definite efficacy on melasma and have been widely used. Tranexamic acid tablets are mainly applied to acute or chronic, limited or systemic hyperfibrinolysis caused by a variety of bleeding, adverse reactions include loss of appetite, nausea, vomiting, etc., is prohibited in the drug components of the allergy, is using thrombin patients. According to the instructions for the use of the drug although there is no tranexamic acid tablets for the treatment of melasma, but in clinical practice, dermatology is often applied to the treatment of epidermal and vascular melasma, belonging to the category of empirical treatment, it is recommended to follow the doctor’s instructions.