A Clinical Study of Melasma and a Comparison of the Therapeutic Effect of Certain Currently Available Topical Modalities for its Treatment

BACKGROUND: Melasma is a common acquired facial hypermelanosis. Conventional treatment of melasma includes a sunscreen and hypopigmenting agents. The treatment of this recalcitrant disorder is often difficult and unsatisfactory. AIMS: The objective is to carry out a detailed clinical study of melasma and to assess the therapeutic effect and side effects of certain currently available topical modalities for the treatment of melasma. MATERIALS AND METHODS: 160 patients of all age groups and both sexes were treated sequentially with five different combination regimes for 3 months. Assessment of the response was done subjectively as well as by melasma area and severity index (MASI). RESULTS: Out of the five modalities studied, the modified Kligman's formula was the most effective. However, it had comparatively higher incidence of side effects. CONCLUSIONS: Among the currently available topical modalities for the treatment of melasma, the most effective combination is the modified Kligman's formula. However, in view of the side effects it causes, it must be used with caution and proper counseling.