title: Melasma: a comprehensive update: part II.
abstract: Several methods of treatment are available to patients with melasma. First-line therapy usually consists of topical compounds that affect the pigment production pathway, broad-spectrum photoprotection, and camouflage. Second-line therapy often consists of the addition of chemical peels, although these must be used cautiously in patients with darker skin. Laser and light therapies represent potentially promising options for patients who are refractory to other modalities, but also carry a significant risk of worsening the disease. A thorough understanding of the risks and benefits of various therapeutic options is crucial in selecting the best treatment.
authors.affiliation: Department of Dermatology at Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Vaneeta M
authors.initials: VM
authors.lastname: Sheth
authors.affiliation: Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: amit.pandya@utsouthwestern.edu.
authors.forename: Amit G
authors.initials: AG
authors.lastname: Pandya
mesh_terms: D000287:Administration, Topical; D044466:Asian People; D002615:Chemexfoliation; D003998:Dicarboxylic Acids / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006016:Glycolates / Q000627:therapeutic use; D006035:Glycyrrhiza; D006801:Humans; D006873:Hydroquinones / Q000627:therapeutic use; D028022:Low-Level Light Therapy / Q000009:adverse effects; D008543:Melanins / Q000037:antagonists & inhibitors / Q000096:biosynthesis; D008548:Melanosis / Q000532:radiotherapy / Q000628:therapy*; D014442:Monophenol Monooxygenase / Q000037:antagonists & inhibitors; D010789:Phototherapy; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use; D011753:Pyrones / Q000627:therapeutic use; D013473:Sunscreening Agents / Q000627:therapeutic use; D016896:Treatment Outcome; D014212:Tretinoin / Q000627:therapeutic use; D014466:Ultraviolet Rays / Q000009:adverse effects
chemical_list: D003998:Dicarboxylic Acids; D006016:Glycolates; D006873:Hydroquinones; D008543:Melanins; D010936:Plant Extracts; D011753:Pyrones; D013473:Sunscreening Agents; C031149:glycolic acid; D014212:Tretinoin; C011890:kojic acid; D014442:Monophenol Monooxygenase; C010038:azelaic acid