Medical therapies for melasma.

Autor: Mahajan VK; Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra, India., Patil A; Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, India., Blicharz L; Department of Dermatology, Medical University of Warsaw, Warsaw, Poland., Kassir M; Worldwide Laser Institute, Dallas, USA., Konnikov N; Boston University School of Medicine, Boston, Massachusetts, USA., Gold MH; Gold Skin Care Center, Tennessee Clinical Research Center, Nashville, Tennessee, USA., Goldman MP; Cosmetic Laser Dermatology: A West Dermatology Company, San Diego, California, USA.; Department of Dermatology, University of California, San Diego, California, USA., Galadari H; College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates., Goldust M; Department of Dermatology, University Medical Center Mainz, Mainz, Germany.
Jazyk: angličtina
Zdroj: Journal of cosmetic dermatology [J Cosmet Dermatol] 2022 Sep; Vol. 21 (9), pp. 3707-3728. Date of Electronic Publication: 2022 Jul 31.
DOI: 10.1111/jocd.15242
Abstrakt: Melasma is a common malady affecting all races with a higher incidence in Hispanics, Middle Eastern, Asians, and African origin females (Fitzpatrick skin phototypes III-V). Women are affected much more often than men. Melasma remains a significant cause of cosmetic morbidity and psychosocial embarrassment affecting quality of life necessitating effective and reliable treatment. Unfortunately, treatment remains unsatisfactory due to limited efficacy, adverse effects, and relapses after stopping treatment. Although chemical peels, laser and light therapies and dermabrasion may have utility, the evidence available for their efficacy is limited and they often cause post-inflammatory hyperpigmentation, particularly in individuals with darker skin types. Medical therapies remain mainstay in the management of melasma. The triple combination, hydroquinone 4%, tretinoin 0.05%, and fluocinolone acetonide 0.01% (Triluma, Galderma, Ft. Worth Texas, often modified incorporating different corticosteroids) remains the only US FDA-approved treatment for melasma and is the gold standard due its demonstrated efficacy across ethnicities. Oral tranexamic acid alone or in combination with other modalities has also shown significant efficacy. Several cosmeceuticals and botanical extracts used as skin lightening agents have been demonstrated to be useful. Physical sunscreens containing zinc oxide, iron oxide, titanium dioxide, and silicones provide photoprotective and camouflage effect. We propose that a multimodality approach to the treatment of melasma is the most effective treatment approach. This review is focused on the medical therapies for melasma.
(© 2022 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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