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Treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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This condition is difficult to treat.

  • patients with melasma should use a sunscreen effective against both UVA and UVB with sun protection factor of 15 or greater; also should avoid the midday sun
  • physical treaments include:
    • laser treatment has little to offer in the treatment of this condition (1)
    • chemical peels - there has been reported improvement in patients treated with glycolic acid peels
  • topical treatments include:
    • hydroquinone - this is the most commonly used treatment for melasma (2)
      • triple combination (TC) cream is a stable combination of fluocinolone acetonide 0.01%, hydroquinone 4%, and tretinoin 0.05% and is currently the only FDA-approved drug for the treatment of melasma - it is the only FDA-approved agent containing hydroquinone (2)
    • tretinoin - works very slowly - the lightening of the melasma is often not apparent until afte 24 weeks of treatment
    • azelaic acid - this has been shown to be an effective treatment for melasma - of the three topical treatments described, it is the easiest to use and best tolerated (1)
    • intense pulsed light therapy has been used to treat melasma (3)

Reference:

  • (1) Dermatology in practice (2001), 9 (5), 20-21.
  • (2) Gupta AK et al. The treatment of melasma: A review of clinical trials Journal of the American Academy of Dermatology 2006; 55(6): 1048-1065
  • (3) Journal of the American Academy of Dermatology 2008; 58 (2): Supplement 2, AB116

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