![]() Topical treatments rank high among commonly used melasma therapies. Dermatologists and other providers might consider peels as a third-line therapy, with glycolic acid or trichloroacetic acid (TCA) peels showing the greatest efficacy in outcomes for melasma, according to the paper. Her second-line melasma treatment recommendation is to use lasers, including low-fluence Q-switched Nd:YAG, picosecond laser and pulsed dye lasers for lighter skin types. If there are no contraindications she recommends also adding oral tranexamic acid 250 mg daily to the first-line treatment. Spierings suggests a melasma treatment ladder starting with topical hydroquinone and retinoid-based products as first line for the first three months, at least. She found four clinical trials focused on topical hydroquinone as a first-line option 12 papers on tranexamic acid use 19 looking at various novel melasma therapies 42 investigating laser and light treatments and 11 analyzing outcomes of peels for melasma.īased on her findings, Dr. Spierings, B.Sc., M.B.B.S., M.R.C.P.(UK), M.R.C.P (Derm), M.B.A., M.Sc., a consultant dermatologist at Queen Mary University of London, UK, conducted a literature search in July 2019, looking for English-language studies published on melasma treatments in the last decade. That’s according to a literature review on clinical trial evidence for melasma treatments, published October 11, 2019, in the Journal of Cosmetic Dermatology.Īuthor Natalia M. The low-fluence Q-switched laser remains one of the best laser and light options for treating melasma, especially in darker types.Īnd overall studies suggest that chemical peels do not have better melasma treatment outcomes than topical therapy. The science suggests tranexamic acid is a very promising melasma treatment. ![]() There’s strong evidence supporting the use of hydroquinone as a first-line treatment for melasma. ![]()
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