Melasma in Latin America: options for therapy and treatment algorithm

Cestari, Tania F.; Arellano, I; Hexsel, Dóris; Jp, Ortonne

doi:10.1111/j.1468-3083.2009.03251.x

Cited by 67 publications

(59 citation statements)

References 70 publications

(144 reference statements)

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“…Among various etiologic factors including genetic predisposition and hormonal influences, exposure to UV light plays key role in pathogenesis of melasma. Melasma is often refractory to chemical peels, topical therapy with hydroquinone, retinoids, azelaic or kojic acids due to resistance to the agent and rapid recurrence of the lesion (1)(2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Treatment of melasma by low-fluence 1064 nm Q-switched Nd:YAG laser

Sim

Park

Lee

et al. 2013

Journal of Dermatological Treatment

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Section: Introductionmentioning

confidence: 99%

Treatment of melasma by low-fluence 1064 nm Q-switched Nd:YAG laser

Sim

Park

Lee

et al. 2013

Journal of Dermatological Treatment

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“…1,2 Depigmenting agents are commonly prescribed; inhibition of tyrosinase (TYR) is the most common approach to achieving skin hypopigmentation. [1][2][3][4][5] Many TYR inhibitors have been identified in vitro, but few exert therapeutic effects in clinical trials. Among the skinlightening and spot-removing agents are hydroquinone, tretinoin (retinoic acid), kojic acid (KA), azelaic acid, arbutin, and glabridin.…”

Section: Introductionmentioning

confidence: 99%

MITF-siRNA Formulation Is a Safe and Effective Therapy for Human Melasma

et al. 2011

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It is unclear whether siRNA-based agents can be a safe and effective therapy for diseases. In this study, we demonstrate that microphthalmia-associated transcription factor-siRNA (MITF-siR)-silenced MITF gene expression effectively induced a significant reduction in tyrosinase (TYR), tyrosinase-related protein 1, and melanocortin 1 receptor (MC1R) levels. The siRNAs caused obvious inhibition of melanin synthesis and melanoma cell apoptosis. Using a novel type of transdermal peptide, we developed the formulation of an MITF-siR cream. Results demonstrated that hyperpigmented facial lesions of siRNA-treated subjects were significantly lighter after 12 weeks of therapy than before treatment (P < 0.001); overall improvement was first noted after 4 weeks of siRNA treatment. At the end of treatment, clinical and colorimetric evaluations demonstrated a 90.4% lightening of the siRNA-treated lesions toward normal skin color. The relative melanin contents in the lesions and adjacent normal skin were decreased by 26% and 7.4%, respectively, after treatment with the MITF-siR formulation. Topical application of siRNA formulation significantly lightens brown facial hypermelanosis and lightens normal skin in Asian individuals. This treatment represents a safe and effective therapy for melasma, suggesting that siRNA-based agents could be developed for treating other diseases such as melanoma.

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“…Conventional treatments usually fail to induce long-term remission, as is commonly seen with the use of first-line therapies such as Kligman's formula. 3,4 This fact has prompted the search for innovative treatments to manage the disease. It is the case of non-ablative fractioned lasers, which have been established to treat melasma after initial positive results by Rokhs & Fitzpatrick (2005).…”

Section: Introductionmentioning

confidence: 99%

The use of ablative lasers in the treatment of facial melasma

Morais

Lemos

Sousa

et al. 2013

An. Bras. Dermatol.

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Melasma represents a pigmentary disorder that is difficult to treat. This study aims to broadly review the use of ablative lasers (Er:YAG and CO2) in the treatment of melasma, presenting the level of evidence of studies published to date. A total of 75 patients were enrolled in four case series studies (n=39), one controlled clinical trial (n=6) and one randomized controlled clinical trial (n=30). Studies on the Er:YAG laser showed better results with the use of short square-shaped pulses, which determined low rates of post-inflammatory hyperpigmentation and long-lasting maintenance of results. Likewise, studies on the CO2 laser proved the benefits of short pulse duration along with low-density energy. Post-treatment maintenance with the use of antipigmenting creams was necessary and effective to sustain long-term results. Ablative lasers may represent another useful and effective tool against melasma. Postinflammatory hyperpigmentation and difficulty in sustaining long-term results still represent the main limitations to a broader use of ablative lasers. Based on actual evidence, the use of this technology should be restricted to patients with recalcitrant disease. Further studies will help establish optimal laser parameters and treatment regimens.

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Melasma in Latin America: options for therapy and treatment algorithm

Abstract: Objective/Aim To examine approaches to therapy for melasma in Latin Americans and to propose treatment algorithms for patients with mild, moderate and severe melasma.Background Melasma is prevalent in up to 10% of the Latin American population. It is found in all racial groups and is

Cited by 67 publications

References 70 publications

Treatment of melasma by low-fluence 1064 nm Q-switched Nd:YAG laser

Treatment of melasma by low-fluence 1064 nm Q-switched Nd:YAG laser

MITF-siRNA Formulation Is a Safe and Effective Therapy for Human Melasma

The use of ablative lasers in the treatment of facial melasma

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