Melasma Treatment Strategies in Skin Health
Summary
Melasma is a chronic, acquired hyperpigmentation disorder typically affecting sun‐exposed areas of the face, with profound psychosocial impact. Its multifactorial pathogenesis involves melanogenic stimulation by ultraviolet radiation, hormonal fluctuations and inflammatory mediators, underpinned by genetic predisposition. Standard management emphasises rigorous photoprotection combined with topical depigmenting agents such as hydroquinone, retinoids and chemical exfoliants to inhibit tyrosinase activity and melanosome transfer. Adjunctive therapies include antioxidants to mitigate oxidative stress, and hormone‐modulating agents such as tranexamic acid, which also demonstrates anti‐angiogenic properties. Procedural interventions—ranging from superficial chemical peels and laser therapies to novel minimally invasive techniques such as microneedling—target epidermal and dermal components of melasma. Recent research has expanded mechanistic understanding of vascular contributions, basement membrane integrity and extracellular matrix remodelling, informing emerging strategies that integrate molecular inhibitors with combination regimens. Despite advances, individual response varies and recurrence remains a challenge, highlighting the need for personalised, multifaceted approaches and long‐term maintenance protocols.
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Melasma Treatment Strategies in Skin Health publication trend
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Technical terms
Melasma: A chronic hyperpigmentation disorder characterised by brown macules on sun‐exposed skin, most commonly the face.
Melanin: The pigment produced by melanocytes that determines skin colour and accumulates in melasma lesions.
Tyrosinase: A key enzyme in melanin synthesis targeted by many depigmenting agents to reduce pigmentation.
Reactive oxygen species (ROS): Unstable molecules generated by ultraviolet exposure that promote melanocyte stimulation and inflammation.
Tranexamic acid: A plasmin inhibitor with anti‐inflammatory and anti‐angiogenic properties used orally, topically or via intradermal injection in melasma treatment.
Microneedling: A minimally invasive procedure using fine needles to create micropores, enhancing topical drug penetration and stimulating dermal remodelling.
References
- The Impact of Antioxidants on Vitiligo and Melasma: A Scoping Review and Meta-Analysis. Antioxidants (2023).
- Tranexamic Acid for Adults with Melasma: A Systematic Review and Meta‐Analysis. BioMed Research International (2018).
- Efficacy of functional microarray of microneedles combined with topical tranexamic acid for melasma. Medicine (2017).
- Heterogeneous Pathology of Melasma and Its Clinical Implications. International Journal of Molecular Sciences (2016).
- Tranexamic Acid Inhibits Angiogenesis and Melanogenesis in Vitro by Targeting VEGF Receptors. International Journal of Medical Sciences (2020).
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