Which topical ingredients have evidence for melasma?

What question did the researchers ask?

The analysis included 45 studies with 2,359 patients for efficacy and 55 studies with 4,539 patients for adverse effects, comparing several topical ingredient families used for melasma.

What did they actually find?

Hydroquinone combinations, cysteamine, tranexamic acid, azelaic acid and kojic acid were associated with improvement. Irritation varied considerably, with higher reported rates for hydroquinone combinations and cysteamine.

What should you keep in mind?

The paper assesses ingredients across studies and is not a product-specific trial of Cosmelan. Melasma is recurrent and treatment selection must account for diagnosis, skin tone, tolerance, sun exposure and maintenance.

What does this mean for a Highfield consultation?

This is melasma evidence across topical agents, not a product-specific endorsement of Cosmelan. We consider that finding alongside independent guidance, your medical history, examination and priorities. It can support a better-informed decision, but it cannot promise a personal result or decide whether treatment is suitable.