Table 10.

Bad prognosis factors

Factors that govern negative treatment outcome
Phenotype III–VI: dark hair and/or dark skin
Genetic and familial predisposition [3, 6, 8–10]
Long-term melasma in spite of ≥2 years of treatment
History of procedural interventions
Treated by ≥2 physicians
Long-term self-treatment with steroids [46, 47]
Ochronosis [76, 114]
Mixed-type melasma [115]