LAUSR

Treatments for many common dermatologic diagnoses are denied insurance coverage due to their arbitrary cosmetic classification. Melasma is one such diagnosis often considered cosmetic by payers, and since it is commonly identified in darker-skinned individuals, its cosmetic classification creates an economic barrier for patients of color. Although dermatologists have previously described insurance coverage gaps for conditions typically seen in patients of color, this coverage gap has never been quantified.1 Thus, we investigated the rate of insurance coverage for first-line topical treatments for rosacea versus melasma. Rosacea and melasma share a number of key features - both are common, chronic, dermatological conditions that are exacerbated by sun exposure, are primarily treated topically, and cause measurably decreased quality of life in affected patients.2,3 Rosacea, however, is often diagnosed in patients with Fitzpatrick skin types I-II, with 91.8% of rosacea diagnoses seen in white patients, while melasma is predominantly diagnosed in patients with Fitzpatrick skin types III-V.4-6.