Medical therapies for melasma

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.