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Melasma (epidermal)
Compare the procedure groups used for this indication, ranked by evidence grade. Each grade comes from an expert read of the actual studies (design, quality, on-topic relevance); direction reflects what those studies conclude.
| Grade | Direction | Procedure group | RCT & meta | Clinical & observational | Case reports | Total papers |
|---|---|---|---|---|---|---|
| A | Mixed | Picosecond laser pigment | 23 | 7 | 7 | 58 |
| A | Supported | Fractional picosecond resurfacing | 7 | 2 | 0 | 24 |
| A | Supported | Chemical peel | 24 | 22 | 8 | 121 |
| B | Mixed | Laser toning qswitched or picosecond | 39 | 20 | 13 | 125 |
| B | Mixed | Nonablative fractional resurfacing | 5 | 4 | 1 | 24 |
| B | Supported | Ionzyme iontophoresis sonophoresis | 6 | 4 | 2 | 15 |
| F | Insufficient | Needle free drug delivery | 0 | 0 | 0 | 0 |