Treatment of Melasma/Chloasma

Standard of Care

• The standard of care for melasma/chloasma includes strict sun protection with broad-spectrum sunscreen, first-line topical therapies such as hydroquinone, tretinoin, or triple combination formulations, oral tranexamic acid, and procedural treatments like platelet-rich plasma injections or microneedling in refractory cases 1, 2
• The American Academy of Dermatology conditionally recommends clascoterone for patients with acne, but it is not included in guidelines for melasma management 3

Evidence-Based Treatment Options

• Oral tranexamic acid 250 mg twice daily is an evidence-based treatment option for melasma 1
• Compounded cream, likely containing hydroquinone and/or other depigmenting agents, is part of an evidence-based regimen for melasma 2
• Laser therapy and sun protection factor products are also part of the standard treatment plan for melasma 1, 2

Guideline Recommendations

• The 2025 Melasma Treatment Guidelines do not mention clascoterone as a treatment option for melasma 1, 2
• The patient's current regimen of tranexamic acid, compounded cream, laser therapy, and sun protection represents the standard of care for melasma 1, 2