Managing melasma in a clinical setting requires a nuanced understanding of its complex pathophysiology. Because melasma is a chronic condition that is not necessarily curable, the primary therapeutic objective is long-term, effective management. For dermatologists treating moderate to severe cases, achieving optimal clearance requires both a trusted standard of care and a comprehensive, multi-targeted strategy.

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In this Next Steps in Derm video interview, conducted in conjunction with the Pigmentary Disorders Exchange Symposium, Rebecca Vasquez, MD, FAAD, shares why hydroquinone remains the undisputed gold standard for pigment suppression in moderate to severe melasma. Dr. Vasquez, associate professor in the Department of Dermatology at UT Southwestern Medical Center, details the role of hydroquinone in comparison with alternative interventions, such as tranexamic acid.

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To achieve the most optimal clinical results, Dr. Vasquez recommends a multimodal treatment plan. By concurrently utilizing therapies that suppress melanocyte activity, downregulate inflammation, and target underlying vascularity, clinicians can address every facet of the disease process. This comprehensive approach not only improves initial clearance but also provides superior long-term control for patients navigating this challenging condition.