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Author Spotlight: Non-Surgical Treatment of Melasma– Microneedling with Tranexamic Acid
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Medical therapies for melasma.

Vikram K Mahajan1, Anant Patil2, Leszek Blicharz3

  • 1Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra, India.

Journal of Cosmetic Dermatology
|July 20, 2022
PubMed
Summary

Melasma treatments are often unsatisfactory. A multimodality approach combining medical therapies, like the FDA-approved Triluma, offers the most effective strategy for managing this common skin condition.

Keywords:
chemical peelscosmeceuticalshydroquinonenatural ingredientstranexamic acid

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Area of Science:

  • Dermatology
  • Cosmetic Science

Background:

  • Melasma is a prevalent skin condition causing cosmetic concerns and psychosocial distress, particularly in women with Fitzpatrick skin types III-V.
  • Current treatments for melasma often yield unsatisfactory results due to limited efficacy, adverse effects, and high relapse rates.
  • Existing procedures like chemical peels and laser therapies have limited evidence and can cause post-inflammatory hyperpigmentation, especially in darker skin tones.

Purpose of the Study:

  • To review the medical therapies available for melasma treatment.
  • To highlight the efficacy of established and emerging treatments for melasma.

Main Methods:

  • Review of existing literature on melasma treatments.
  • Focus on medical therapies, including topical combinations, oral medications, cosmeceuticals, and sunscreens.

Main Results:

  • The triple combination of hydroquinone, tretinoin, and fluocinolone acetonide (Triluma) is the only US FDA-approved melasma treatment and a gold standard due to its efficacy across ethnicities.
  • Oral tranexamic acid, alone or in combination, shows significant efficacy.
  • Physical sunscreens offer photoprotection and camouflage.

Conclusions:

  • A multimodality approach is proposed as the most effective treatment strategy for melasma.
  • Medical therapies are the cornerstone of melasma management.
  • Further research into effective and reliable melasma treatments is warranted.