Melatonin and oxidative stress in melasma ‒ an unexplored territory; a prospective study

Abstract

Background Melasma, an acquired disorder of hyperpigmentation, is the most common pigmentary disorder in India. Many factors are implicated in the pathogenesis, and recently the role of oxidative damage including melatonin has been postulated. This study was undertaken to evaluate the role of oxidative stress and serum melatonin in pathogenesis of melasma.Methods Seventy-five patients with melasma and an equal number of age and sexmatched controls were included in the study. Clinical characteristics were noted, and baseline severity assessment using modified Melasma Area and Severity Index (MASI) was done in all patients. Serum melatonin, catalase, protein carbonyl, and nitric oxide levels were measured and compared between cases and controls. ResultsThe serum levels of melatonin and catalase were significantly lower among the cases as compared to controls, while the serum levels of protein carbonyl and nitric oxide were significantly higher in cases compared to controls. There was no statistically significant correlation between these markers of oxidative stress and severity of the disease. ConclusionsOxidative stress is increased in patients with melasma compared to the control group in this study. A state of melatonin deficit also exists in patients with melasma.No correlation between the oxidative stress and severity of the disease was found. Further and larger studies including therapeutic trials with powerful antioxidants are warranted. * P < 0.05 is statistically significant.

French maritime pine bark extract (pycnogenol) in association with triple combination cream for the treatment of facial melasma in women: a double‐blind, randomized, placebo‐controlled trial

“…Some antioxidants have been indicated to have variable success in the treatment of melasma, 35–43 and oral pycnogenol has been previously proposed following non‐controlled trials with various regimens of treatment.…”

“…[30][31][32][33] However, welldesigned and adequately powered trials are still needed to establish its posology and precise value in the management of other chronic diseases. 34 Some antioxidants have been indicated to have variable success in the treatment of melasma, [35][36][37][38][39][40][41][42][43] and oral pycnogenol has been previously proposed following non-controlled trials with various regimens of treatment.…”

Update on Melasma—Part I: Pathogenesis

“…Melatonin also inhibits UV-light-mediated synthesis of iNOS, and it can influence the metabolism of MSH, estrogen, and progesterone [ 79 ]. Serum levels of melatonin and catalase are lower among patients with melasma compared with controls, while serum levels of protein carbonyl and NO are higher [ 80 ]. Notably, a preliminary report has indicated promising results after topical and oral use of melatonin in melasma [ 81 ].…”

Melazma Tedavisinde Güncel Yaklaşımlar Ve Olası Toksik Etkileri

“…UV ışınları doğrudan veya dolaylı olarak keratinositlerden veya fibroblastlardan salınan melanosit stimüle edici hormon (MSH), adrenokortikotropik hormon (ACTH) gibi proopiomelanokortin (POMC) kaynaklı peptitler, endotelin-1 (ET-1), kök hücre faktörü (SCF), temel fibroblast büyüme faktörü (bFGF), sinir büyüme faktörü (NGF) veya mast hücrelerinden sentezlenen histamin gibi melanogenik faktörlerin protein kinaz C (PKC), nitrik oksit (NO) ve siklik AMP (cAMP) gibi hücre içi sinyal iletim yolaklarını aktive etmesi aracılığıyla melanogenezi indükler (Şekil 1) [4,9,10].…”