Melasma in Latin America: options for therapy and treatment algorithm.

Area of Science:

• Dermatology
• Pigmentary Disorders

Background:

• Melasma affects up to 10% of the Latin American population, common in darker skin types.
• Topical treatments, especially hydroquinone, are prevalent but require careful use to prevent side effects.
• Assessing melasma severity is essential for effective treatment selection.

Purpose of the Study:

• To analyze melasma treatment approaches in Latin Americans.
• To develop treatment algorithms for mild, moderate, and severe melasma cases.

Main Methods:

• A review of 31 clinical studies on topical treatments, chemical peels, and laser therapies.
• Evidence quality assessment by the Latin American Pigmentary Disorders Academy.
• Integration of diagnostic guidelines and success assessment methods.

Main Results:

• For mild melasma: hydroquinone 4%, triple combination cream, or double combination therapy.
• For moderate-to-severe melasma: triple combination cream is first-line; double combination or hydroquinone 4% as second-line.
• Sun avoidance and high-SPF broad-spectrum sunscreens are fundamental for successful management.

Conclusions:

• Established treatment algorithms provide a structured approach to melasma management in Latin Americans.
• Personalized treatment selection based on severity and patient factors is key.
• Consistent sun protection is a non-negotiable component of melasma therapy.