Evidence-based review, grade of recommendation, and suggested treatment recommendations for melasma

Treatment of melasma is known to be less satisfactory, often incomplete, and relapse is frequent. Although many treatment options are available, they are either known to be unsafe on long-term use or their long-term safety profile is unknown. Patients often use various drugs, even topical steroid-ba...

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Main Authors: Nilendu Sarma, Sayantani Chakraborty, Shital A Poojary, Sanjay Rathi, Sendhil Kumaran, Balakrishnan Nirmal, Joan Felicita, Rashmi Sarkar, Prashansa Jaiswal, Paschal D'Souza, Nagaraju Donthula, Sumit Sethi, Pallavi Ailawadi, Bebisha Joseph
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2017-01-01
Series:Indian Dermatology Online Journal
Subjects:
Online Access:http://www.idoj.in/article.asp?issn=2229-5178;year=2017;volume=8;issue=6;spage=406;epage=442;aulast=Sarma
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author Nilendu Sarma
Sayantani Chakraborty
Shital A Poojary
Sanjay Rathi
Sendhil Kumaran
Balakrishnan Nirmal
Joan Felicita
Rashmi Sarkar
Prashansa Jaiswal
Paschal D'Souza
Nagaraju Donthula
Sumit Sethi
Pallavi Ailawadi
Bebisha Joseph
author_facet Nilendu Sarma
Sayantani Chakraborty
Shital A Poojary
Sanjay Rathi
Sendhil Kumaran
Balakrishnan Nirmal
Joan Felicita
Rashmi Sarkar
Prashansa Jaiswal
Paschal D'Souza
Nagaraju Donthula
Sumit Sethi
Pallavi Ailawadi
Bebisha Joseph
author_sort Nilendu Sarma
collection DOAJ
description Treatment of melasma is known to be less satisfactory, often incomplete, and relapse is frequent. Although many treatment options are available, they are either known to be unsafe on long-term use or their long-term safety profile is unknown. Patients often use various drugs, even topical steroid-based preparation without any medical supervision for long period of time, making the skin unsuitable for many of the drugs available. Thus, there has been gross disparity among the treating physician about what drugs and what regimen are best suitable for various categories of melasma patients and in different situations. With this background, numerous newer drugs, mostly combinations of some proprietary molecules or even unknown plant extracts, have flooded the market for the management of melasma. Information on efficacy or safety of these products are almost unknown. Studies on Asian people, especially Indian population, are far less commonly available. Therapeutic guideline for use on Indian patients with melasma is almost missing. Extrapolation of data from Caucasian people for use on Asian people may not be scientifically justifiable because Caucasian and Asian people are known to have inherent difference in their response as well as tolerance to the drugs used for melasma. With this background, we have extensively evaluated, following a strict, scientifically designed protocol, all the available studies on melasma management till May 2016 and prepared this document on level of evidence, grade of recommendation and suggested therapeutic guideline for melasma as per the method proposed by Oxford Centre of Evidence-Based Medicine. Various ethical, social, logical, regional, and economic issues in the context of Indian and similar populations were given due importance while preparing the suggested therapeutic recommendation.
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spelling doaj.art-1ea35859ac8b41a388da6da8d1e0323e2022-12-21T17:48:52ZengWolters Kluwer Medknow PublicationsIndian Dermatology Online Journal2229-51782017-01-018640644210.4103/idoj.IDOJ_187_17Evidence-based review, grade of recommendation, and suggested treatment recommendations for melasmaNilendu SarmaSayantani ChakrabortyShital A PoojarySanjay RathiSendhil KumaranBalakrishnan NirmalJoan FelicitaRashmi SarkarPrashansa JaiswalPaschal D'SouzaNagaraju DonthulaSumit SethiPallavi AilawadiBebisha JosephTreatment of melasma is known to be less satisfactory, often incomplete, and relapse is frequent. Although many treatment options are available, they are either known to be unsafe on long-term use or their long-term safety profile is unknown. Patients often use various drugs, even topical steroid-based preparation without any medical supervision for long period of time, making the skin unsuitable for many of the drugs available. Thus, there has been gross disparity among the treating physician about what drugs and what regimen are best suitable for various categories of melasma patients and in different situations. With this background, numerous newer drugs, mostly combinations of some proprietary molecules or even unknown plant extracts, have flooded the market for the management of melasma. Information on efficacy or safety of these products are almost unknown. Studies on Asian people, especially Indian population, are far less commonly available. Therapeutic guideline for use on Indian patients with melasma is almost missing. Extrapolation of data from Caucasian people for use on Asian people may not be scientifically justifiable because Caucasian and Asian people are known to have inherent difference in their response as well as tolerance to the drugs used for melasma. With this background, we have extensively evaluated, following a strict, scientifically designed protocol, all the available studies on melasma management till May 2016 and prepared this document on level of evidence, grade of recommendation and suggested therapeutic guideline for melasma as per the method proposed by Oxford Centre of Evidence-Based Medicine. Various ethical, social, logical, regional, and economic issues in the context of Indian and similar populations were given due importance while preparing the suggested therapeutic recommendation.http://www.idoj.in/article.asp?issn=2229-5178;year=2017;volume=8;issue=6;spage=406;epage=442;aulast=SarmaGuidelinehydroquinoneIndiamelasmatreatmenttriple combination
spellingShingle Nilendu Sarma
Sayantani Chakraborty
Shital A Poojary
Sanjay Rathi
Sendhil Kumaran
Balakrishnan Nirmal
Joan Felicita
Rashmi Sarkar
Prashansa Jaiswal
Paschal D'Souza
Nagaraju Donthula
Sumit Sethi
Pallavi Ailawadi
Bebisha Joseph
Evidence-based review, grade of recommendation, and suggested treatment recommendations for melasma
Indian Dermatology Online Journal
Guideline
hydroquinone
India
melasma
treatment
triple combination
title Evidence-based review, grade of recommendation, and suggested treatment recommendations for melasma
title_full Evidence-based review, grade of recommendation, and suggested treatment recommendations for melasma
title_fullStr Evidence-based review, grade of recommendation, and suggested treatment recommendations for melasma
title_full_unstemmed Evidence-based review, grade of recommendation, and suggested treatment recommendations for melasma
title_short Evidence-based review, grade of recommendation, and suggested treatment recommendations for melasma
title_sort evidence based review grade of recommendation and suggested treatment recommendations for melasma
topic Guideline
hydroquinone
India
melasma
treatment
triple combination
url http://www.idoj.in/article.asp?issn=2229-5178;year=2017;volume=8;issue=6;spage=406;epage=442;aulast=Sarma
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