Knowledge, attitude, and practice of board-certified dermatologists in Shiraz, Iran toward melasma management and their adherence to the recent dermatology guidelines

Background and aim of the work: Melasma is a common hyperpigmentation skin disorder that is more prevalent in females. Due to the negative effect of melasma on self-esteem and quality of life, early diagnosis and management would be essential. Although numerous therapeutic regimens have been considered, melasma treatment is still challenging and the desired clinical response cannot be achieved in some patients. Research design and Methods: In this knowledge, attitude, and practice (KAP) survey, the point of views, approaches, and concepts of board-certified dermatologists toward melasma treatment were assessed. This KAP survey was performed through a standard questionnaire containing 9 questions which were distributed among the board-certified dermatologists who were practicing in various dermatology clinics or hospital wards of Shiraz, Iran. The obtained results were compared with the recommendations of various recent updated dermatology guidelines. Results: The results revealed that dermatologists’ perspectives and attitudes toward melasma management showed good adherence to the recommendations of the dermatology guidelines. About 78% of dermatologists recommended topical preparations as the preferred route of administration for melasma management and about 80% of them recommended topical hydroquinone as the first-line treatment. Conclusions: Although hydroquinone-containing topical formulations are efficient depigmenting agents for melasma treatment, concerns regarding their adverse drug reactions, especially in prolonged administration, still remained and demands are growing for the design and development of novel formulations and more efficacious delivery systems to reduce the adverse drug reactions of currently used medications and also to enhance therapeutic outcomes.