Melasma Drug Summary

Apply to affected area 12 hourly x 6 months
Re-evaluate after 4-12 weeks

Adverse Reactions

• Usually resolve with continued use or by decreasing frequency of application: Skin irritation, pruritus, burning
• Hypopigmentation, photosensitivity

•  Avoid exposure to excessive sunlight or UV radiation
• Avoid contact with eyes

Apply a few drops on cleansed face and leave for 10-20 minutes
Wash off with cold water afterwards

Adverse Reactions

• Irritation, redness

• Test on a small area of the skin behind the ear prior to application
• Avoid contact with eyes
• Apply sunscreen and avoid sun exposure during use

Apply to affected area 12 hourly

Adverse Reactions

• Irritant contact dermatitis, erythema, occasional  photosensitivity
• Paradoxical hyperpigmentation with high concentration

•  Use with caution in patients <12 years old

Apply to affected area 12 hourly

Adverse Reactions

• Irritant contact dermatitis, erythema, occasional photosensitivity

• Clean area prior to application and pat dry
• Avoid contact with eyes and other mucous membranes

• Irritant contact dermatitis, erythema, occasional photosensitivity

• Clean area prior to application and pat dry
• Use with caution in patients <12 years old
• Avoid contact with eyes 

• Irritant contact dermatitis, erythema, occasional photosensitivity

• Clean area prior to application and pat dry
• Avoid contact with eyes

• Dry skin, erythema, burning sensation, irritation

• Wash face thoroughly prior to application
• Avoid sun exposure during use

• Skin irritation, erythema, pruritus, burning

• Use with caution in patients at risk for thrombotic complications

Apply to affected area 12 hourly

Adverse Reactions

• Irritant dermatitis, contact dermatitis, mild burning, transient erythema, post-inflammatory pigmentation, ochronosis and nail bleaching

• Test for skin sensitivity before using product by applying to small area of unbroken skin (minor redness is not a contraindication, but discontinue if itching, vesicle formation, or excessive inflammatory response occurs)
• Contraindicated in patients <12 years old
• Discontinue use if no lightening effect is noted after 2 months of treatment
• Discontinue if a gradual blue-black darkening of the skin occurs

24 mg PO 12-24 hourly

Adverse Reactions

• GI effect (GI upset)

• Take with food

• Usually resolve with decreasing frequency of application: Stinging, feeling of warmth, erythema, peeling
• Edema, blistering, crusting of the skin, temporary hypo- or hyperpigmentation, photosensitivity

• Start with weaker formulation and increase concentration as tolerated
• Avoid exposure to excessive sunlight or UV radiation

Adverse Reactions

• GI upset

Special Instructions

• Should be taken with food; take after meals

Adverse Reactions

• GI upset

Special Instructions

• Should be taken with food; take after meals

Apply 24 hourly during night time to the affected area

Adverse Reactions

• Hypersensitivity reactions

• Avoid contact with eyes

Apply 24 hourly 30 minutes before bedtime on lesions and 0.5 cm of surrounding skin

Adverse Reactions

• Erythema, desquamation, burning, dryness, pruritus at application site 

• Not to be used with occlusive dressing 
• Use with caution in patients with Cushing's syndrome, hyperglycemia, glucosuria, visual disturbance (eg cataract, glaucoma, central serous chorioretinopathy)
• Avoid excessive exposure to sunlight, sunlamp or UV light, weather extremes (eg heat or cold), and application to eyes, nose or mouth angles

• Dry skin, cracked skin around the nose and eyes, erythema

• Avoid contact with eyes, mouth, nose angle, thin skin, or mucous membranes
• Avoid sun exposure during treatment
• Contraindicated in patients ≤12 years old