INTRODUCTION
Melasma, a symmetric pigmentary disorder, develops primarily on the face.1 Melasma typically presents as light brown to dark brown macules and patches on the forehead, malar region, and chin.1 Melasma is more prevalent in women and individuals with darker skin tones.1 Melasma is attributed to multiple etiologies, including ultraviolet (UV) sun exposure, hormonal influences, pregnancy, cosmetics, birth control, and antiseizure or phototoxic drugs.1-3 Although the precise age of onset varies, melasma generally occurs between 20 to 30 years of age.3 The global prevalence worldwide is estimated to be around 1%, while in higher-risk populations, the prevalence has been found to range from 9% to 50%.2 Melasma not only leads to considerable psychological and emotional distress but also significantly affects a patient’s quality of life.4,5 This impact is particularly pronounced in patients with skin of color, who experience a higher frequency of melasma and greater associated morbidity.4,5
The prevalence of melasma varies by race, and existing data on melasma prevalence is often limited to the demographics of specific locations where studies are performed. The prevalence of melasma in Latino populations ranges from 8.2% to 8.8%, while an Arab-American population in Michigan showed a 15.5% prevalence rate.6,7,8 In contrast, the prevalence of melasma was found to be 4% in a black population in Durban, South Africa.9 The prevalence of melasma was found to be 2.9% in Saudi Arabia and 1.5% in Ethiopia.10,11 The prevalence in India is as high as 41.1%.12 Asian countries such as Nepal and China also report prevalence rates of 6.8% and 13.6%, respectively.13,14
As the demographic landscape of the United States continues to diversify, with one in three Americans projected to be a race other than White by 2060, the need for inclusivity in dermatologic research becomes increasingly necessary.15 Racial minorities are often underrepresented in dermatology clinical trials, including trials involving hidradenitis suppurativa (HS), nail psoriasis, psoriatic arthritis, and laser treatments for scars.16-20 There is currently a gap in knowledge pertaining to patient representation in melasma clinical trials. Given the documented underrepresentation of skin of color participants in dermatologic clinical trials and the higher prevalence of melasma within these populations, we aim to analyze gender, racial, and Fitzpatrick skin type (FST) representation in melasma clinical trials.16-20
The prevalence of melasma varies by race, and existing data on melasma prevalence is often limited to the demographics of specific locations where studies are performed. The prevalence of melasma in Latino populations ranges from 8.2% to 8.8%, while an Arab-American population in Michigan showed a 15.5% prevalence rate.6,7,8 In contrast, the prevalence of melasma was found to be 4% in a black population in Durban, South Africa.9 The prevalence of melasma was found to be 2.9% in Saudi Arabia and 1.5% in Ethiopia.10,11 The prevalence in India is as high as 41.1%.12 Asian countries such as Nepal and China also report prevalence rates of 6.8% and 13.6%, respectively.13,14
As the demographic landscape of the United States continues to diversify, with one in three Americans projected to be a race other than White by 2060, the need for inclusivity in dermatologic research becomes increasingly necessary.15 Racial minorities are often underrepresented in dermatology clinical trials, including trials involving hidradenitis suppurativa (HS), nail psoriasis, psoriatic arthritis, and laser treatments for scars.16-20 There is currently a gap in knowledge pertaining to patient representation in melasma clinical trials. Given the documented underrepresentation of skin of color participants in dermatologic clinical trials and the higher prevalence of melasma within these populations, we aim to analyze gender, racial, and Fitzpatrick skin type (FST) representation in melasma clinical trials.16-20
