COMPARATIVE STUDY OF MELASMA TREATMENT IN BLACK WOMEN: TOPICAL THERAPIES AND

Abstract

Melasma is a multifactorial dermatological condition characterized by irregular and recurrent hyperpigmentation, with a high prevalence in Black women (phototypes IV to VI). Although effective therapies exist, challenges remain regarding safety and the risk of post-inflammatory hyperpigmentation (PIH) in this group. This narrative review comparatively analyzes the main topical therapies—such as hydroquinone, glycolic acid, kojic acid, and tretinoin—and aesthetic procedures, including diamond peeling and laser therapy, based on ten articles published in the last decade. The findings indicate that milder active ingredients, such as kojic acid and glycolic acid in low concentrations, offer a better safety profile for Black skin. More potent substances, such as hydroquinone and tretinoin at 0.1%, require caution due to their greater irritant potential and risk of PIH. Diamond peeling can act as a complementary method, but requires precise technique. Laser therapy, especially with non-ablative fractional lasers such as the QS Nd:YAG, shows promising results when applied with specific protocols for high phototypes. It is concluded that the management of melasma in Black women should be individualized, prioritizing less irritating active ingredients, rigorous photoprotection, and minimally inflammatory approaches.