2025-10-29 10:13:52
Presenters: Leung BW1
Affiliations: 1Department of Dermatology, Baylor College of Medicine
Background: Melasma is a common pigmentary disorder with variable therapeutic approaches. However, limited large-scale data describe prescribing trends for topical agents in the United States.
Objective: To evaluate national trends in prescription topical medications used for melasma management over the past decade.
Methods: This was a cross-sectional population-level study of patients with a diagnosis of melasma. Using Epic Cosmos database, 40,145 patients were identified using ICD-10 codes from June 30, 2015 to June 30, 2025. Prescription frequencies for tretinoin, hydroquinone, and azelaic acid were reported as proportions of patients with melasma diagnosis per calendar year.
Results: From 2015 to 2025, prescription rates increased for all three agents. Tretinoin use remained highest throughout, rising from 23.6% in 2015 to 26.1% in 2025, with a transient dip in 2021 (17.8%). Hydroquinone use increased from 18.9% to 27.6%, with the steepest growth occurring between 2020 and 2024. Azelaic acid, although less frequently prescribed, showed the largest relative increase (2.7x), from 2.4% to 6.5% over the study period.
Conclusions: In this large, population-level dataset, prescription topical therapies for melasma showed an upward trend from 2015–2025, with hydroquinone and azelaic acid exhibiting the greatest relative growth.
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