Melasma Treatment: An Evidence-Based Review
McKesey J, Tovar-Garza A, Pandya AG
Published in Am J Clin Dermatol, Vol. 21 (2), pp. 173-225
Methodology
Evidence-based review of randomised and controlled clinical trials of melasma treatments found by a systematic PubMed search through October 2018, plus Cochrane systematic reviews.
Key Findings
113 studies with 6,897 participants were included, covering topical agents, chemical peels, lasers and light devices, and oral agents. Triple combination cream (hydroquinone, tretinoin and a corticosteroid) and hydroquinone alone were the most effective and best-studied treatments. Oral tranexamic acid was a promising treatment for moderate and severe recurrent melasma.
Conclusions
Hydroquinone and triple combination cream remain the most effective treatments; peels, lasers and light are equal or inferior to topicals with more side effects; oral tranexamic acid may be a safe adjunct but needs longer-term study.
Limitations
PubMed-only search of English-language trials; included studies were heterogeneous, small and short, with little long-term follow-up.
Related Health Concerns
Study Details
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