TABLE 1.
Scales used for investigator evaluations
| MELASMA SEVERITY | MELASMA PIGMENTATION INTENSITY | MELASMA IMPROVEMENT | ERYTHEMA | DRYNESS | PEELING | BURNING/STINGING |
|---|---|---|---|---|---|---|
| None (0) No noticeable lesion area | None (0) No noticeable lesion area | Worse | None—no erythema present | None | None | Normal, no discomfort |
| Minimal/trace (1) Melasma covering 1-10% of face | Minimal (1) Localized deposits of pigment | Unchanged—no detectable improvement from baseline evaluation | Trace erythema | Slight flaking | Trace, localized peeling | Trace, awareness without discomfort |
| Mild (2 or 3) Melasma covering 11-25% of face | Mild (2 or 3) Mild, diffuse deposits of pigment | Slight improvement (1-10%) | Mild erythema | Mild flaking | Mild diffuse peeling | Mild, noticeable discomfort causing intermittent awareness |
| Moderate (4 or 5) Melasma covering 26-40% of face | Moderate (4 or 5) Moderate, diffuse deposits of pigment | Mild improvement (11-25%) | Moderate confluent erythema | Moderate flaking/scaling | Moderate—definitely noticeable peeling | Moderate, noticeable discomfort causing continuous awareness |
| Marked (6 or 7) Melasma covering 41-50% of face | Marked (6 or 7) Marked, dense deposits of pigment | Moderate improvement (26-50%) | Marked erythema, slight edema | Marked scaling, slight fissuring | Marked—dense extensive peeling | Marked, definite discomfort that occasionally interferes with normal daily activities |
| Severe (8) Melasma covering >50% of face | Severe (8) Severe, dense deposits of pigment | Marked improvement (51-75%) | Severe erythema, edema, flare, possible erosion | Severe scaling, fissuring | Severe—extensive peeling | Severe, marked, continuous discomfort that interferes with normal daily activities |
| – | – | Almost complete clearing (76-99% improvement) | – | – | – | – |
| – | – | Complete clearing, no signs of hyperpigmentation (100% improvement) | – | – | – | – |