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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]

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however, this effect was far less than that observed for carnitine ( Figure 5A )

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