New Mechanistic Insights of Melasma

Liu, Wei; Chen, Qin; Xia, Yumin

doi:10.2147/ccid.s396272

Cited by 32 publications

(50 citation statements)

References 78 publications

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“…2 Melasma is categorised as epidermal, dermal, or mixed form based on the location of the pigment by Wood's lamp examination. 3 Even if the ultraviolet light exposition and hormonal influences seem to be the most influencing factors in the appearance of symptoms, the aetiology is probably multifactorial and not too clear. 4 Indeed, when compared to healthy volunteers, melasma patients have greater melanogenesis and higher markers of oxidative stress, suggesting that UV light both initiates and contributes to the condition.…”

Section: Introductionmentioning

confidence: 99%

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The 675‐nm wavelength for treating facial melasma

Coricciati,

Gabellone,

Donne

et al. 2023

Skin Research and Technology

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BackgroundMelasma is an acquired skin problem. It characterises sun‐exposed areas, particularly on the face, with irregular borders and bilateral distribution. With this study, we want to strengthen the scientific literature regarding the use of a 675‐nm laser device for the treatment of women and men with facial melasma pigmentary and vascular symptoms.Materials and methodsEighteen patients were treated for facial melasma. A total of three sessions at 30‐day intervals were performed with a 675‐nm laser device. A five‐point Global Aesthetic Improvement Scale was used to separately assess the improvement of the patient's skin 3 months after the last treatment (T1) compared to baseline (T0). The pain during treatment was measured using a Visual Analog Scale of 10 points. The non‐ablative laser system used emits red light with a wavelength of 675 nm through a 13 × 13 mm scanning system.ResultsAt T1, a consistent improvement in the pigmentary and vascular components was visible. This is always combined with a considerable reduction in vascular expression.ConclusionOur research shows that individuals with Fitzpatrick phototypes II to III can treat facial melasma with the 675‐nm laser source system without risk. Due to its interaction with melanin, collagen and haemoglobin chromophores, as well as its excellent capacity to penetrate tissues with less heating, this system is promising in the treatment of pigmentary and vascular illnesses such as melasma. The great success of the technology we used came from the reduced levels of inflammation produced after the treatments and the low energy level implied.

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Section: Introductionmentioning

confidence: 99%

“…The centrofacial, malar and mandibular forms of melasma are the three most common 2 . Melasma is categorised as epidermal, dermal, or mixed form based on the location of the pigment by Wood's lamp examination 3 …”

Section: Introductionmentioning

confidence: 99%

The 675‐nm wavelength for treating facial melasma

Coricciati,

Gabellone,

Donne

et al. 2023

Skin Research and Technology

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“…Meanwhile, the etiology of melasma is still unclear. Many factors may contribute to the development of the disease, including genetics, sunlight, endocrine stimulation, oxidative conditions, and morphofunctional changes 4 . Additionally, melasma has adverse psychological effects on numerous patients, such as anxiety disorders, depression, and somatoform disorders 5–9 …”

Section: Introductionmentioning

confidence: 99%

“…Many factors may contribute to the development of the disease, including genetics, sunlight, endocrine stimulation, oxidative conditions, and morphofunctional changes. 4 Additionally, melasma has adverse psychological effects on numerous patients, such as anxiety disorders, depression, and somatoform disorders. [5][6][7][8][9] Treatment options for melasma include systemic treatment, topical treatment, microneedling, peeling, light, and laser therapy.…”

mentioning

confidence: 99%

Efficacy and safety of laser‐related therapy for melasma: A systematic review and network meta‐analysis

Ma,

Gao,

Liu

et al. 2023

J of Cosmetic Dermatology

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BackgroundMelasma is a prevalent, persistent hyperpigmentation disorder that negatively affects the psychological health of patients. However, the treatment outcome remains unsatisfactory due to the complexity of pathogenesis, recurrence characteristics, and relatively high morbidity.ObjectivesTo compare the performance of laser‐related therapies in improving the melasma area severity index (MASI) score of melasma and the occurrence of adverse effects by network meta‐analysis (NMA).MethodsFrom the inception to November 2022, eligible randomized controlled trials were identified. Two investigators independently searched relevant studies from PUBMED, EMBASE, and the Cochrane Library database.ResultsA total of 39 clinical studies with 1394 participants were eligible for enrollment. For efficacy, the NMA demonstrated that Q‐switched Nd: YAG laser + topical medications (QSND+TM) was superior to Q‐switched Nd:YAG laser (QSND) [MD = −4.21 (−6.80, −1.63)], Er: YAG laser + topical medications (ERYL+TM) [MD = ‐3.52 (−6.84, −0.19)], and picosecond laser + topical medications (PICO+TM) [MD = −4.80 (−9.33, −0.27)]. The microneedling + topical medications (MN+TM) was superior to picosecond laser (PICO) [MD = −5.26 (−10.44, −0.08)] and topical medications (TM) [MD = −5.22 (−9.20, −1.23)]. The top five of the surface under the cumulative ranking curve value (SUCRA) are Q‐switched Nd:YAG laser + topical medications (QSND+TM 85.9%), oral tranexamic acid (oTA 80.1%), microneedling + topical medications (MN+TM 79.7%), Q‐switched Nd:YAG laser + intense pulse light (QSND+IPL 78.9%), and fractional carbon dioxide laser + topical medications (FCDL+TM 70.5%).ConclusionsIn conclusion, the Qs‐Nd:YAG laser with topical medications is the first choice for treating melasma according to the SUCRA value. Among the three treatment modalities, namely MN + TM, PICO, and TM, our recommendation favors MN+TM as the superior choice for enhancing the curative efficacy in melasma. However, the actual clinical choice should also take into account the adverse effects, the skin type of the patient, the duration of the disease, and other relevant factors.

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“…[1][2][3] Epidemiological studies have revealed significant variations in the prevalence of melasma across different populations: It is more common in Middle Eastern, East Asian, Mediterranean-African, and South American populations. 4,5 Based on recent data, in Germany, melasma is more common in individuals with intermediate skin phototypes (III, IV, and V), and the female-to-male ratio of melasma cases is approximately 5.12. 6 In Brazil, melasma is also more prevalent in woman (97.5%), preferentially with skin phototypes II, III, and IV.…”

Section: Introductionmentioning

confidence: 99%

Photobiomodulation for melasma treatment: Integrative review and state of the art

Galache,

Sena,

Tassinary

et al. 2023

Photoderm Photoimm Photomed

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PurposePhotobiomodulation therapy (PBM) is a versatile technique for treating skin diseases. Melasma, a chronic hyperpigmentation condition, has recently been associated with vascular features and dermal photoaging and poses significant management challenges. We review the recent literature on melasma etiology and the evidence supporting PBM as a therapeutic modality for melasma treatment.MethodsWe conducted a comprehensive literature search in three different databases from May to August 2023, focusing on studies published in the past 10 years. The inclusion criteria comprised full‐text studies investigating low‐power lasers and/or light‐emitting diodes (LEDs) in in vitro or in vivo models, as well as clinical trials. We excluded studies discussing alternative melasma therapies or lacking experimental data. We identified additional studies by searching the reference lists of the selected articles.ResultsWe identified nine relevant studies. Clinical studies, in agreement with in vitro experiments and animal models, suggest that PBM effectively reduces melasma‐associated hyperpigmentation. Specific wavelengths (red: 630 nm; amber: 585 and 590 nm; infrared: 830 and 850 nm) at radiant exposures between 1 and 20 J/cm2 exert modulatory effects on tyrosinase activity, gene expression, and protein synthesis of melanocytic pathway components, and thus significantly reduce the melanin content. Additionally, PBM is effective in improving the dermal structure and reducing erythema and neovascularization, features recently identified as pathological components of melasma.ConclusionPBM emerges as a promising, contemporary, and non‐invasive procedure for treating melasma. Beyond its role in inhibiting melanogenesis, PBM shows potential in reducing erythema and vascularization and improving dermal conditions. However, robust and well‐designed clinical trials are needed to determine optimal light parameters and to evaluate the effects of PBM on melasma thoroughly.

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New Mechanistic Insights of Melasma

Cited by 32 publications

References 78 publications

The 675‐nm wavelength for treating facial melasma

The 675‐nm wavelength for treating facial melasma

Efficacy and safety of laser‐related therapy for melasma: A systematic review and network meta‐analysis

Photobiomodulation for melasma treatment: Integrative review and state of the art

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