Publication:

Real-world prescribing patterns of topical agents and treatment outcomes in melasma: a retrospective analysis

Background The present study aims to address the existing evidence gap by assessing prescription patterns for melasma management. Additionally, therapeutic effectiveness is measured through the melasma area and severity index (MASI) score over a structured 3 months observational period.

Methods The present study is a retrospective, observational, multicentre study that includes data from dermatology OPD across various centres in India. The primary outcome was the assessment of frequency and type of topical agent prescribed, determining prescribing patterns of topical agents. Secondary outcomes included evaluation of effectiveness and safety of topical agents with changes in MASI score from baseline to 3 months post-treatment. Data from all centres were collected as per the protocol and proforma and compiled to summarize prescribing pattern of topical agents and associated demographic data.

Results The prescribing patterns showed that there was greater use of depigmenting agents. Most frequently used depigmenting agents were kojic acid (KA) (70.72%) and hydroquinone (HQ) (70%). Mean reduction in MASI score of 39.5% was identified from baseline to 3 months post-treatment. Adverse event frequency was relatively minimal. Most patients tolerated the treatment well. Few patients experienced adverse events such as skin irritation (0.46%), erythema (0.24%), peeling (0.18%), and hyperpigmentation (0.16%).

Conclusions This retrospective study provides an understanding of the role of KA and HQ as common prescribing topical agents for the management of melasma, exhibiting a safe and tolerable profile in large sample size. Significant improvement in MASI scores in 3 months suggests therapeutic advantage in routine clinical practice for melasma treatment.