The aim of IMPROVED is to develop core outcome sets for skin diseases and conditions that can be treated by pharmacologic as well as non-pharmacologic interventions, particularly procedures or surgery.   Each outcome set is a separate project and is based on the CSG-COUSIN roadmap, as well as methodologic guidance put forth by COMET.


Melasma is a form of dyspigmentation that presents as confluent gray and tan patches of the face, commonly the upper cheeks, upper lips and forehead.  Hormonal influences may play a role, with incidence in women associated with pregnancy, menopause, and the use of oral contraceptives.  Melasma may also occur in men.

At present, melasma is a treatment-resistant condition that rarely, if ever fully, remits.  Treatment ranges from topical bleaching agents and sunscreen to minimally invasive procedural interventions like low-energy lasers and superficial chemical peels. 

A core outcome set for melasma may enable fine discrimination among outcomes, which may in turn allow precise comparison of the modestly efficacious treatments currently available.  Use of a melasma outcome set may also guide optimization of new treatment approaches.