Future therapies in melasma: What lies ahead?

Sarkar, Rashmi; Bansal, Anuva; Ailawadi, Pallavi

doi:10.4103/ijdvl.ijdvl_633_18

Cited by 55 publications

(59 citation statements)

References 88 publications

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“…Furthermore, oral tranexamic acid has gained popularity for treating melasma and novel VEGF inhibitors show promise. 10,11 The vascular characteristics of FPDL warrant further investigation.…”

Section: Discussionmentioning

confidence: 99%

“…Increased VEGF expression in keratinocytes of melasma‐affected skin has been reported, 9 and VEGF may increase melanin synthesis through VEGF receptors located on melanocytes. Furthermore, oral tranexamic acid has gained popularity for treating melasma and novel VEGF inhibitors show promise 10,11 . The vascular characteristics of FPDL warrant further investigation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A clinical, dermoscopic, histopathological and immunohistochemical study of melasma and facial pigmentary demarcation lines in the skin of color

Khunger

Kandhari²,

Singh

et al. 2020

Dermatologic Therapy

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Melasma and facial pigmentary demarcation lines (FPDL) are common causes of patterned facial pigmentation that may mimic each other. There is a paucity of studies investigating these two conditions. The objective of this study was to make a detailed comparative analysis of these disorders. A clinical, dermoscopic, histopathological and immunohistochemical analysis of lesional and perilesional skin was conducted in 20 patients each of melasma and FDPL. The most common morphological patterns were centrofacial in melasma and W-shaped pattern in FPDL. Dermoscopy in melasma revealed similar patterns in lesional and perilesional skin, whereas FPDL did not. Histopathology of melasma revealed increased melanin in the suprabasal and basal layers (100%), melanophages in the upper dermis and solar elastosis (65%) in contrast to FPDL, wherein increased basilar melanin (75%) and dermal melanophages were the key findings. Expression of vascular endothelial growth factor and stem cell factor was slightly increased in lesional melasma skin, but not in FPDL. The study was limited by its small sample size and immunohistochemistry carried out in a few patients. Melasma and FPDL, although similar in presentation, are distinct entities. Dermoscopy, histology and immunohistochemistry reveal subtle differences.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A clinical, dermoscopic, histopathological and immunohistochemical study of melasma and facial pigmentary demarcation lines in the skin of color

Khunger

Kandhari²,

Singh

et al. 2020

Dermatologic Therapy

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“…New therapies focusing on the multiple causes of hyperpigmentation, such as histamine synthesis, oestrogen upregulation, melanosome transfer and ROS generation, are being studied for the treatment of melasma since the targeting of melanin synthesis alone is not effective enough. Natural agents with a multimodal mechanism of action are being investigated due to their better safety profile compared to conventional drugs [80,81].…”

Section: Future Treatmentsmentioning

confidence: 99%

“…The triple therapy, a combination of HQ, an anti-oestrogen and a vascular endothelial growth factor inhibitor, seems to be the ideal skin-lightening agent [80].…”

Section: Future Treatmentsmentioning

confidence: 99%

Melanogenesis and Melasma Treatment

Maddaleno

Camargo²,

Mitjans

et al. 2021

Cosmetics

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Melanocytes are highly specialised dendritic cells that transfer melanin to keratinocytes in subcellular lysosome-like organelles called melanosomes, where melanin is synthesised and stored. Melanin is a complex pigment that provides colour and photoprotection to the skin, hair, and eyes of mammals. The regulation of melanogenesis includes various mechanisms and factors including genetic, environmental, and endocrine factors. Knowledge of the pigmentation process is important not only to understand hyperpigmentation but also to design treatments and therapies to treat them. Whitening cosmetics with anti-melanogenesis activity are very popular. In the present manuscript, we review the mechanisms and the signalling pathways involved in skin pigmentation and we specifically focus on the alteration of melanogenesis that leads to melasma and results in hyperpigmentation. Finally, current therapies and treatments including topical, oral, and phototherapies are discussed and described, with a special emphasis on the cosmetics’ action.

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“…It commonly occurs in middle-aged women. The etiology of melasma is complex, and related studies have shown that ultraviolet radiation, estrogen level, vascular hyperplasia and skin inflammation are inducing factors [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Platelet-Rich Plasma in Melasma: A Systematic Review and Meta-Analysis

Zhao

Xiao

et al. 2021

Dermatol Ther (Heidelb)

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Introduction: Melasma is a chronic and recurrent skin problem for which an effective therapy is currently lacking. Platelet-rich plasma (PRP) has recently emerged as a novel treatment for melasma, but to date there has been no systematic evaluation of its efficacy and safety. Methods: The Web of Science, PubMed, EMBASE, China National Knowledge Infrastructure (CNKI) and the Cochrane Library databases were searched for relevant articles using the search items ''melasma,'' ''chloasma'' and ''platelet-rich plasma.'' STATA version 15.1 software was used to analyze data. Study outcomes were calculated using standardized mean differences with 95% confidence intervals (CIs). Results: The database search identified ten studies involving 395 adult patients that met the inclusion criteria and were included in the meta-analysis. Analysis of pre-and post-treatment data from these studies revealed that the post-treatment modified Melasma Area and Severity Index (mMASI) score decreased by 1.18 (95% CI 0.89-1.47; p = 0.02). Subjective satisfaction evaluation of PRP treatment showed that melasma treated with the combination therapy of PRP ? microneedling may have been the most efficacious treatment compared to PRP alone or in combination with intradermal injection. Adverse reactions were minor, with only a few patients reporting local congestion, temporary erythema, hyperpigmentation and discoloration. Conclusion: These results support the efficacy and safety of PRP used in combination or alone as treatment for melasma.

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Future therapies in melasma: What lies ahead?

Cited by 55 publications

References 88 publications

A clinical, dermoscopic, histopathological and immunohistochemical study of melasma and facial pigmentary demarcation lines in the skin of color

A clinical, dermoscopic, histopathological and immunohistochemical study of melasma and facial pigmentary demarcation lines in the skin of color

Melanogenesis and Melasma Treatment

Efficacy and Safety of Platelet-Rich Plasma in Melasma: A Systematic Review and Meta-Analysis

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