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Related Experiment Videos

Treatment of melasma.

Marta Rendon1, Mark Berneburg, Ivonne Arellano

  • 1Dermatology and Aesthetic Center, Boca Raton, Florida 33486, USA.

Journal of the American Academy of Dermatology
|April 25, 2006
PubMed
Summary

The Pigmentary Disorders Academy (PDA) recommends fixed triple combination topical therapies as the first-line treatment for melasma. Alternative topical agents or chemical peels are suggested for non-responders, with lasers used sparingly.

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Area of Science:

  • Dermatology
  • Cosmetic Science

Background:

  • Melasma treatment involves various topical depigmenting agents and physical therapies with variable success.
  • The Pigmentary Disorders Academy (PDA) aimed to establish a consensus on melasma management.

Purpose of the Study:

  • To evaluate the clinical efficacy of different melasma treatments.
  • To generate a consensus statement for melasma management.

Main Methods:

  • Systematic review of clinical papers published in the last 20 years via MEDLINE.
  • Assessment of study methodology and outcomes based on USPSTF guidelines.

Main Results:

  • First-line therapy consensus: effective topical treatments, primarily fixed triple combinations.
  • Alternative first-line options: dual or single ingredient topical agents for sensitive patients or unavailability of triple combinations.
  • Second-line therapy for non-responders: chemical peels, alone or with topical treatments.
  • Maintenance therapy: combination topical treatments.
  • Laser use: recommended rarely, with consideration for skin type.

Conclusions:

  • Fixed triple combination topical therapies are the preferred first-line treatment for melasma.
  • A stepwise approach involving alternative topicals, peels, and maintenance therapy is outlined.
  • Judicious use of lasers, considering skin type, is advised for refractory cases.

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