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MelasmaMelasma - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Melasma Last reviewed: February 2019 Last updated: February 2018 Summary A harmless pigmentary disorder, seen primarily on the malar region of women with darker skin. Aetiological factors include hormonal and UV light exposure. Treatment is with topical retinoids, bleaching agents, chemical peels, and laser or light therapy. Sun protection is important (...) for maintaining the effects of treatment. Definition Melasma is an acquired pigmentary disorder of sun-exposed areas. Ball Arefiev KL, Hantash BM. Advances in the treatment of melasma: a review of the recent literature. Dermatol Surg. 2012 Jul;38(7 Pt 1):971-84. http://www.ncbi.nlm.nih.gov/pubmed/22583339?tool=bestpractice.com Characteristically, patients have muddy brown macules on the skin, predominantly in the malar and central facial areas; however, it can also affect areas such as the forearms and neck
The effect of melasma on self-esteem: A pilot study Melasma is a common disorder of hyperpigmentation characterized by tan or brown macules and patches affecting sun-exposed areas, particularly the face. Melasma has been shown to have a significant impact on the quality of life and self-esteem of those affected. We interviewed six patients who were diagnosed with moderate-to-severe melasma with regard to the effect of their disorder on their self-esteem. All patients reported a significant (...) negative effect on their quality of life and self-esteem. With successful therapy using a triple combination of cream and oral tranexamic acid to treat their melasma, all reported a marked improvement in self-esteem. Physicians who treat patients with melasma should be aware of its profound psychosocial effects and the improvement that successful melasma treatment can have on self-esteem.
A review of laser and light therapy in melasmaMelasma is a dysregulation of the homeostatic mechanisms that control skin pigmentation and excess pigment is produced. Traditional treatment approaches with topical medications and chemical peels are commonly used but due to the refractory and recurrent nature of melasma, patients often seek alternative treatment strategies such as laser and light therapy. Several types of laser and light therapy have been studied in the treatment of melasma (...) a benefit. Vascular-specific lasers do not appear to be effective for the treatment of melasma. Ablative fractionated lasers should be used with caution because they have a very high risk for postinflammatory hypo- and hyperpigmentation. The use of nonablative fractionated laser treatments compared with other laser and light options may result in slightly longer remission intervals. Picosecond lasers, fractional radiofrequency, and laser-assisted drug delivery are promising future approaches to treat
Interventions for melasma. Melasma is an acquired symmetrical pigmentary disorder where confluent grey-brown patches typically appear on the face. Available treatments for melasma are unsatisfactory.To assess interventions used in the management of all types of melasma: epidermal, dermal, and mixed.In May 2010 we searched the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (Clinical Trials) in The Cochrane Library, MEDLINE, EMBASE, PsycINFO (...) a different set of interventions. They can be grouped into those including a bleaching agent such as hydroquinone, triple-combination creams (hydroquinone, tretinoin, and fluocinolone acetonide), and combination therapies (hydroquinone cream and glycolic acid peels), as well as less conventional therapies including rucinol, vitamin C iontophoresis, and skin-lightening complexes like Thiospot and Gigawhite.Triple-combination cream was significantly more effective at lightening melasma than hydroquinone
Cost-effectiveness of a fixed combination of hydroquinone/tretinoin/fluocinolone cream compared with hydroquinone alone in the treatment of melasma Cost-effectiveness of a fixed combination of hydroquinone/tretinoin/fluocinolone cream compared with hydroquinone alone in the treatment of melasma Cost-effectiveness of a fixed combination of hydroquinone/tretinoin/fluocinolone cream compared with hydroquinone alone in the treatment of melasma Cestari T, Adjadj L, Hux M, Shimizu M R, Rives V P (...) Record Status This is an economic evaluation that meets the criteria for inclusion on NHS EED. CRD summary The authors' objective was to assess the cost-effectiveness of triple combination therapy applied once daily compared with a single therapy applied twice daily for the treatment of moderate to severe melasma. In all countries the cost per primary success was lower for triple combination therapy. The level of bias in the clinical trial is unclear. The cost of treatment across settings varies