University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository




Thomas Colletti


Purpose: The purpose of this article is to review the current modalities for the treatment of melasma, success rates, and novel therapies with positive outcomes.

Method: A comprehensive search and review of published literature from the past five years in such databases as PubMed, Google Scholar, and Medline utilizing key words of melasma, hydroquinone, TXA and laser was performed. A total of 20 articles were identified and reviewed to support this article that may serve as a guideline for the treatment of melasma.

Results: Hydroquinone (HQ), in conjunction with topical steroid and tretinoin, remain standard of care for melasma. However, the addition of topical and oral tranexamic acid (TXA), as well as energy-based devices, have shown good results in suppressing melasma without the need for prolonged HQ use.

Conclusion: The disfiguring nature of melasma is associated with decreased quality of life, depression, and anxiety. Historically standard of care treatments have provided sub-optimal results with high rates of recurrence. New topical/oral agents and light-based devices show promise in the treatment of melasma with a lower side effect profile when compared to the current standard of care.


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