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Background: Various topical agents have been used to treat melasma; however, a large‐scale evaluation among the currently available treatment is lacking. Objectives: The aim of this study was to evaluate the efficacy and safety of topical agents for melasma. Methods: The MEDLINE, Embase, Web of Science, Cochrane, and Alt‐Healthwatch databases were searched in November 2021. Original studies that reported pre‐ and post‐treatment Melasma Area Severity Index (MASI)/modified Melasma Area Severity Index (mMASI) scores and/or adverse effects (AEs) were eligible for inclusion. The main outcome was the efficacy analyzed by the changes in the pre‐ and post‐treatment with standardized mean difference (SMD) of MASI/mMASI scores; the AEs were calculated with incidence proportion by the reported percentage of skin irritations. Results: A total of 45 studies (2359 patients) and 55 studies (4539 patients) met the inclusion criteria for efficacy and AEs, respectively. Hydroquinone (HQ) monotherapy (SMD ‐1.3, 95% CI [−1.6 to −1.0]), HQ‐containing combination therapy (−1.4, [−1.7 to −1.1]), cysteamine (−1.6, [−2.0 to −1.2]), tranexamic acid (−1.5, [−2.0 to −1.1]), azelaic acid (−1.3, [−1.7 to −1.0]), and kojic acid (−0.9, [−1.3 to −0.5]) demonstrated comparable efficacy, while zinc sulfate did not exhibit statistically significant improvement (−1.2, [−2.7 to 0.4]). HQ‐containing combination therapy (50.9%) and cysteamine (42.2%) demonstrated the highest incidence of irritation, while azelaic acid (18.7%), kojic acid (5.3%), and tranexamic acid (0.8%) revealed a lower risk. Conclusions: In this meta‐analysis, non‐HQ agents except zinc sulfate may be considered as an alternative to HQ‐containing agents. However, treatment should be guided by patient's tolerance, availability, and physicians' experience. [ABSTRACT FROM AUTHOR]

Highly textured hair has been found to be more susceptible to breakage than other hair types due to an increased proportion of spirals and relatively fewer elastic fibers anchoring the hair follicles to the dermis. Women of African descent frequently employ hairstyles and hair treatments for ease of management and as a form of selfexpression, but a number of these practices have been implicated as risk factors for alopecia. Herein, we provide an overview of hairstyles for patients with highly textured hair so that physicians may better identify high-risk hairstyles, provide individualized recommendations for safer alternatives, and manage and stop the progression of hair loss before it becomes permanent. [ABSTRACT FROM AUTHOR]

Skin lightening (SL) for cosmetic reasons is associated with profound negative impacts on well-being and adverse effects on the skin, resulting in immense challenges for dermatologists. Despite current regulations, lightening agents continue to dominate the cosmetic industry. In this review, our international team of dermatologists tackles the topic of SL as a global public health issue, one of great concern for both women's health and racial implications. We have examined SL in Africa, Asia, the Middle East, and the Americas. We aim to inspire a global discourse on how modern dermatologists can utilize scientific evidence and cultural competency to serve and protect patients of diverse skin types and backgrounds. In doing so, we hope to promote healthy skin and inclusive concepts of beauty in our patients and society., (© 2020 Published by Elsevier Inc. on behalf of Women's Dermatologic Society.)