aRTicle | dermatology |
treatment options for
melasma: an update
Ilaria Ghersetich, Andrea Bassi, Silvia Betti, Piero Campolmi, and Torello
Lotti review the literature with regard to treatment options for melasma, as
well as offering a scientific background to the condition
ABSTRACT Introduction: Melasma is a typical hypermelanosis, and quite a common dermatological skin disease, which involves sun exposed areas of the skin and mostly affects women of reproductive age. Hyperpigmentation is the result of an increase in cutaneous melanin deposition.
Method: Different treatment options are currently available for melasma. This article aims to review the literature pertaining to these treatment options to inform evidence-based practice.
ILARIA GHERSETICH, ANDREA BASSI, SILVIA BETTI, PIERO CAMPOLMI, and TORELLO LOTTI are based at the Department of Dermatology, University of Florence, Italy
email:
bassi76@interfree.it
Discussion: In mixed and epidermal melasma, the increasingly popular combination of chemical peels (especially superficial — 30% salicylic acid and 10% tretinoin mask) with pharmacologic treatment (hydroquinone, azelaic acid, kojic acid) is a good treatment option. In dermal melasma, physical treatments can be considered, such as intense pulsed light therapy (even though only temporary and transient results are achieved in the authors’ experience), or with fractional laser skin resurfacing (fractional photothermolysis), a new approach using vascular lasers for skin rejuvenation.
KEYWORDS melasma, topical treatment, physical treatment, chemical peeling
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Conclusions: Melasma continues to be a challenge with regard to treatment options. All melasma patients should be made aware that ultraviolet exposure is a significant triggering or aggravating factor in the development of melasma. The choice of treatment in the melasma patient should take into account the type of melasma to be treated, the skin complexion of the patient, and possible previous treatments.
July 2011 |
prime-journal.com
occurring symmetrically on sun-exposed areas of the body, most commonly the face1, 2
M mostly affects women of reproductive age1, 3 factors. Histological immunohistochemical studies4
and ultraviolet (UV) exposure are the best known aetiologic
elasMa is a coMMonly acquired, localised disorder of hyperpigmentation, characterised by irregular brown or grayish– brown macules and patches with well-defined margins, usually
. This typical disease , and solar
and have indicated that
melasma skin shows features of prominent solar damaged skin. UV irradiation is known to increase the synthesis of alpha-melanocyte-stimulating hormones (MsH) and adrenocorticotropic hormones (acTH) derived from pro-opiomelanocortin (PoMc) in keratinocytes. These peptides lead to the proliferation of melanocytes, as well as an increase in melanin synthesis via stimulation of tyrosinase activity and human tyrosinase related protein-1 (TRP-1)3
. Studies have shown that melasma is characterised by
alterations in the dermal structures in addition to pigmentary changes, suggesting the role of the dermal
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