Melasma: Updates and perspectives

Abstract

Management of melasma is highly challenging due to inconsistent treatment results and frequent relapses. However, recent studies revealed that melasma may not only be a disease of melanocytes, but also a photoaging skin disorder. Herein, we attempt to validate that melasma is indeed a photoaging disorder by presenting the histopathologic findings of melasma: solar elastosis, altered basement membrane, increased vascularization and increased mast cell count. We also provide some therapeutic implications based on these findings and a discussion on the latest updates and perspectives regarding treatment.

Focus Theme Issue: “Vitiligo and other pigmentary disorders”

“…Melasma is the most common acquired hypermelanosis characterized by macules on sun‐exposed areas of the skin, especially the face of middle‐aged women, suggesting female hormone influences. Kwon et al, from Seoul, South Korea, present a comprehensive review on the challenging management of melasma and conclude that melasma represents an abnormal photoageing pigmentary pattern, which deserves specific antiageing approaches . Muriel Cario, from Bordeaux, France, suggests that sex steroid hormones, especially oestrogen, are not able to induce hyperpigmentation alone, but act in synergy with UVB, with variable susceptibility according to an individual's specific disposition/constitution.…”

Efficacy of liposome‐encapsulated 4‐n‐butylresorcinol and resveratrol cream in the treatment of melasma

“…Melasma is a common acquired hypermelanotic skin condition characterized by reticulated brown‐colored macules on sun‐exposed areas, especially the face. High prevalence of melasma was reported in Asian women in their thirties or forties . Chronic ultraviolet (UV) exposure, female sex hormone stimulation, and predisposed genetic background have been proposed to contribute to the development of melasma .…”

“…High prevalence of melasma was reported in Asian women in their thirties or forties . Chronic ultraviolet (UV) exposure, female sex hormone stimulation, and predisposed genetic background have been proposed to contribute to the development of melasma . Several therapeutic modalities for melasma have been proposed, including topical depigmenting agents, oral administration of tranexamic acid (TXA), energy‐based devices, and chemical peel .…”

“…Chronic ultraviolet (UV) exposure, female sex hormone stimulation, and predisposed genetic background have been proposed to contribute to the development of melasma . Several therapeutic modalities for melasma have been proposed, including topical depigmenting agents, oral administration of tranexamic acid (TXA), energy‐based devices, and chemical peel . Hydroquinone (HQ) is the most popular depigmenting agent, which strongly inhibits tyrosinase, the rate‐limiting step of melanogenesis .…”

“…1 Several therapeutic modalities for melasma have been proposed, including topical depigmenting agents, oral administration of tranexamic acid (TXA), energy-based devices, and chemical peel. 1 Hydroquinone (HQ) is the most popular depigmenting agent, which strongly inhibits tyrosinase, the rate-limiting step of melanogenesis. 2 However, the safety issue of HQ-exogenous ochronosis, permanent depigmentation, and potential carcinogenic risk-has motivated researchers to find alternative topical agent which is effective as well as safe.…”