The past year in melasma: topical, oral, laser and procedural treatments, each summarised in the MedShorts 360 format with its date and source.
DermatologyA Delphi panel of 22 experts from 14 countries recommends treating active vitiligo first and using lasers and peels only with caution.
DermatologyAdding an intradermal hyaluronic acid–glutathione booster to low-fluence Q-switched Nd:YAG and oral TXA gave greater, more durable mMASI reduction.
DermatologyIn a split-face trial, both PRP types improved mMASI equally, but activated PRP gave a greater objective melanin reduction at 12 weeks.
DermatologyTen RCTs show several natural products performed comparably to 4% hydroquinone with mild side effects.
DermatologyIn 30 women, mostly with skin types IV–VI, a topical serum reduced hyperpigmentation by about a third over 16 weeks.
DermatologyAcross 11 studies, platelet-rich plasma did not significantly improve melasma severity compared with control therapies.
DermatologyA meta-analysis found no significant difference between the two microneedling adjuncts over 6–16 weeks.
DermatologyInjected TXA at 4 mg/mL or 100 mg/mL often matched or beat hydroquinone and oral TXA, with lower recurrence than laser.
DermatologyIn a split-face study of 57 patients, metformin reduced hemi-MASI by 53% versus 61% with Kligman's formula.
DermatologyCombining picosecond Alexandrite laser with NCTF 135 HA gave 75% pigment reduction versus 40% with laser alone, and fewer recurrences.
DermatologyBoth regimens reduced epidermal melanin; the ketotifen combination also reduced solar elastosis and basement-membrane damage.
DermatologyThree sessions reduced mean MASI from 18.3 to 8.2 in 30 women, with 86.7% satisfaction.
DermatologyIn 99 women, picosecond laser reduced mMASI by 40.7% after five sessions versus 29.5% with low-fluence Q-switched laser.
DermatologyAcross 31 studies and 2,801 patients, the combination gave higher efficacy (92.0% vs 77.4%) and lower recurrence (8.5% vs 17.8%).
DermatologyIn a split-face trial of 30 patients with skin types III–IV, fractional microneedle radiofrequency improved melasma, and PRP mainly helped redness.
DermatologyIn five RCTs, triple combination cream gave greater MASI reduction, and the laser caused more post-inflammatory hyperpigmentation.
DermatologyEleven RCTs with 461 patients show growing benefit from 8 weeks onwards when lasers or light are combined with topicals.
DermatologyOver 12 weeks, the yeast-derived compound matched 4% hydroquinone for brightening and MASI reduction with mild side effects.
DermatologyPooling 34 studies, oral and topical drugs and chemical peels reduced both MASI and MELASQoL scores.
DermatologyIn 120 patients, more achieved ≥60% improvement with microneedling (30.0%) than with 15% TCA peels (16.7%).
DermatologyLaser therapy, most often 1064-nm Q-switched Nd:YAG, significantly improved MASI scores across 471 patients.
DermatologyAlternating IPL and microneedling with a postbiotic formulation gave greater mMASI reductions than IPL alone over 12 weeks.
DermatologyAcross eight studies, cysteamine reduced MASI by a mean of 5.73 points with only mild irritation.
DermatologyIn 99 patients, both niosomal and conventional TXA/niacinamide creams were as effective as 4% hydroquinone, while only hydroquinone caused adverse reactions and relapse.
DermatologyIn 27 patients, mMASI fell from 5.43 to 3.39, and 74% achieved good physician-rated improvement.