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Nowadays, non\u2010invasive skin imaging techniques, such as reflectance confocal microscopy (RCM), have been used to estimate pigment distribution and depth within different skin layers. This article aims to provide a systematic review of RCM applications in melasma, providing terminology and investigating characteristics of melasma at baseline and after medical and laser treatment. Our results support the recognition of two main types of melasma, epidermal and mixed type, thanks to the role of RCM in highlighting the precise pigment depth location in the skin non\u2010invasively. RCM treatment monitoring enables the objectification of pigment variations after treatment and the identification of prognostic factors for different treatment modalities. After the era of the application of RCM as a technique applied strictly to skin cancers, additional cosmetic applications are emerging, such as the application of melasma treatment monitoring.<\/jats:p>","DOI":"10.1111\/ijd.17117","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T07:07:29Z","timestamp":1709795249000},"page":"1007-1012","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Melasma and reflectance confocal microscopy: from baseline to treatment monitoring"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8221-6694","authenticated-orcid":false,"given":"Stefania","family":"Guida","sequence":"first","affiliation":[{"name":"School of Medicine, Vita\u2010Salute San Raffaele University  Milan Italy"},{"name":"Dermatology Clinic, IRCCS San Raffaele Hospital  Milan 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