ABSTRACT
The histological features of melasma and chloasma are discussed elsewhere in this book. The standard recommendations for treatment often mention only the topical applications tretinoin, hydroquinone, fluorinated corticosteroids, sun protection, and tyrosinase inhibitors; chemical peels are considered as a last resort because of their potential to turn melasma into postinflammatory hyperpigmentation (PIH). Conventional peels require conscientious prepeel preparation to avoid this danger. Easy TCA (ETCA), in combination with appropriate postpeel care, can be used to treat melasma without the constraints of prepeel preparation (Figures 16.1-16.5). Laser therapy is not recommended for treating melasma because lasers are difficult to use and have been linked to many common side effects. The numerous evolutions and promises of laser therapy have not solved these problems.
