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dermatology

MASI — Melasma Area and Severity Index

Standard quantitative melasma severity score (Kimbrough-Green 1994, modified Pandya 2011). Total 0–48 (0–24 for mMASI). Used in clinical trials and PROM monitoring.

Score interpretation

Mild melasma 1

→ Daily broad-spectrum SPF 50+ (mineral preferred); avoid heat / friction; topical Kligman trio (hydroquinone 4% + tretinoin 0.05% + fluocinolone 0.01%) 8 weeks; tranexamic acid 250 mg BD (off-label).

Moderate melasma 2

→ Continue topical regime; consider chemical peels (glycolic acid, mandelic acid); oral tranexamic acid 250–500 mg BD for 3 months.

Severe / refractory melasma 3

→ Specialist dermatology input. Q-switched / fractionated lasers (use cautiously — risk of post-inflammatory hyperpigmentation). Combination peels + lasers. Long-term photoprotection critical to prevent recurrence.

Interpretation bands for the MASI. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.