Abstract

A COMPREHENSIVE REVIEW OF MELASMA ETIOLOGY, PATHOGENESIS, DIAGNOSIS, AND TREATMENTS

Jessy Shaji* and Shamika Surendra Parab

ABSTRACT

Melasma is an acquired, under-diagnosed, chronic, therapeutically difficult, universally relapsing hyperpigmentation disorder characterized by greyish-brown spots on the skin, mainly on the face. It primarily affects women and those with Fitzpatrick skin types three to five. Melasma affects the quality of life and self-esteem of patients. The overall prevalence varies from 1-50%, this value is calculated within a specific geographic and ethnic population. Excessive sun exposure, genetic susceptibility, hormonal abnormalities, and the use of phototoxic medications are all etiological factors. Melasma is being treated with a variety of topical, procedural, and oral treatments. Treatment approaches for melasma include UV protecting agents such as Polypodium leucotomos and Iron oxide. Hydroquinone, kojic acid, and arbutin are examples of traditional topical skin lighteners. Some newer oral and topical agents include tranexamic acid, glutathione, melatonin, cysteamine, and pigment correcting serum. Other therapies, such as chemical peeling agents, cosmetic camouflage, dermabrasion, laser, and light therapy, are used to treat melasma as primary or adjuvant therapy. This article highlights some new, advanced, emerging oral and topical treatments, briefly mentions about newer chemical peels and laser treatments for melasma.

Keywords: Melasma, Hyperpigmentation, Ultraviolet, Photoprotection, chemical peels, laser.