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1. Melasma

Melasma Melasma - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Melasma Last reviewed: February 2019 Last updated: February 2018 Summary A harmless pigmentary disorder, seen primarily on the malar region of women with darker skin. Aetiological factors include hormonal and UV light exposure. Treatment is with topical retinoids, bleaching agents, chemical peels, and laser or light therapy. Sun protection is important (...) for maintaining the effects of treatment. Definition Melasma is an acquired pigmentary disorder of sun-exposed areas. Ball Arefiev KL, Hantash BM. Advances in the treatment of melasma: a review of the recent literature. Dermatol Surg. 2012 Jul;38(7 Pt 1):971-84. http://www.ncbi.nlm.nih.gov/pubmed/22583339?tool=bestpractice.com Characteristically, patients have muddy brown macules on the skin, predominantly in the malar and central facial areas; however, it can also affect areas such as the forearms and neck

2018 BMJ Best Practice

2. Role of oxidative stress in melasma: a prospective study on serum and blood markers of oxidative stress in melasma patients. (PubMed)

Role of oxidative stress in melasma: a prospective study on serum and blood markers of oxidative stress in melasma patients. Melasma is a common pigmentary disorder presenting in the dermatological clinic. Many factors have been implicated in the pathogenesis, however, the cause still remains elusive. Recently the effect of oxidative damage has been proposed in the etiopathogenesis of melasma. This study was undertaken to evaluate the role of oxidative stress in patients with melasma.Fifty (...) patients with melasma, age 18 years of age and older, and an equal number of age and sex-matched controls were included in the study. Baseline severity assessment using the modified Melasma Area and Severity Index (modified MASI score) was done in all patients. Serum malondialdehyde, blood superoxide dismutase, and blood glutathione peroxidase levels were measured in cases and controls group and results were compared.The serum levels of malondialdehyde, superoxide dismutase, and blood glutathione were

2017 International Journal of Dermatology

3. Oral and topical tranexamic acid in the treatment of melasma: systematic review

Oral and topical tranexamic acid in the treatment of melasma: systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email

2019 PROSPERO

4. A review of laser and light therapy in melasma (PubMed)

A review of laser and light therapy in melasma Melasma is a dysregulation of the homeostatic mechanisms that control skin pigmentation and excess pigment is produced. Traditional treatment approaches with topical medications and chemical peels are commonly used but due to the refractory and recurrent nature of melasma, patients often seek alternative treatment strategies such as laser and light therapy. Several types of laser and light therapy have been studied in the treatment of melasma (...) a benefit. Vascular-specific lasers do not appear to be effective for the treatment of melasma. Ablative fractionated lasers should be used with caution because they have a very high risk for postinflammatory hypo- and hyperpigmentation. The use of nonablative fractionated laser treatments compared with other laser and light options may result in slightly longer remission intervals. Picosecond lasers, fractional radiofrequency, and laser-assisted drug delivery are promising future approaches to treat

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2017 International journal of women's dermatology

5. Efficacy of oral traditional Chinese medicine combined with oral tranexamic acid in the treatment of melasma: a systematic review

Efficacy of oral traditional Chinese medicine combined with oral tranexamic acid in the treatment of melasma: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record

2019 PROSPERO

6. The effect of melasma on self-esteem: A pilot study (PubMed)

The effect of melasma on self-esteem: A pilot study Melasma is a common disorder of hyperpigmentation characterized by tan or brown macules and patches affecting sun-exposed areas, particularly the face. Melasma has been shown to have a significant impact on the quality of life and self-esteem of those affected. We interviewed six patients who were diagnosed with moderate-to-severe melasma with regard to the effect of their disorder on their self-esteem. All patients reported a significant (...) negative effect on their quality of life and self-esteem. With successful therapy using a triple combination of cream and oral tranexamic acid to treat their melasma, all reported a marked improvement in self-esteem. Physicians who treat patients with melasma should be aware of its profound psychosocial effects and the improvement that successful melasma treatment can have on self-esteem.

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2017 International journal of women's dermatology

7. Melasma and thyroid disorders: a systematic review and meta-analysis. (PubMed)

Melasma and thyroid disorders: a systematic review and meta-analysis. Thyroid hormones may play a key role in melasma; however, melasma link with thyroid disorders remains controversial.To compare the serum levels of thyroid-stimulating hormone (TSH), T4, T3, anti-thyroid peroxidase (anti-TPO), and antithyroglobulin between patients with melasma and control group using meta-analysis.We screened 10 databanks and search engines, searched mesh and nonmesh terms. The identified evidences were (...) reviewed and quality assessed using the Newcastle-Ottawa Scale (NOS). The heterogeneity between the primary results was investigated using Cochrane and I-square indices. Random effect model was applied to combine the standardized mean differences of thyroid function indicators between patients with and without melasma. P values meta-analysis was used to investigate the association between anti-TPO and melasma.We included seven studies, 473 cases, and 379 controls that had been investigated. The total

2019 International Journal of Dermatology

8. How hormones may modulate human skin pigmentation in melasma: an in vitro perspective. (PubMed)

How hormones may modulate human skin pigmentation in melasma: an in vitro perspective. Melasma is a common acquired hyperpigmentary disorder occurring primarily in photo-exposed areas and mainly affecting women of childbearing age. To decipher the role of sex hormones in melasma, this viewpoint reviews the effects of sex hormones on cutaneous cells cultured in monolayers, in coculture, in 3D models and explants in the presence or the absence of UV. The data show that sex steroid hormones (...) hypothesize that in predisposed persons, sex steroid hormones initiate hyperpigmentation in melasma by amplifying the effects of UV on melanogenesis via direct effects on melanocytes or indirect effects via keratinocytes and on the transfer of melanosomes. They also help to sustain hyperpigmentation by increasing the number of blood vessels and, in turn, the level of endothelin-1.© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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2019 Experimental Dermatology

9. Topical silymarin versus hydroquinone in the treatment of melasma: A comparative study. (PubMed)

Topical silymarin versus hydroquinone in the treatment of melasma: A comparative study. Melasma is a highly prevalent hyperpigmentation disorder with a high relapsing rate and a negative impact on the psychological state of the affected patients. The exact pathogenesis of melasma is not completely elucidated; however, ultraviolet induced oxidative stress has an important role in its pathogenesis. Silymarin, antioxidant drug, reduces the harmful effects of solar ultraviolet radiation (...) such as inflammation, immune responses, DNA damage, and pigmentation.To assess the efficacy and safety of topical silymarin with different concentrations (0.7% and 1.4%) versus hydroquinone 4% in the treatment of melasma.Forty-two adult female patients with melasma were assigned to three equal groups each containing 14 patients; group1 was treated by silymarin 0.7% cream, group 2 was treated by silymarin 1.4% cream and group 3 was treated by hydroquinone 4% cream. The duration of treatment was 3 months.MASI score

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2019 Journal of cosmetic dermatology

10. Effective Tyrosinase Inhibition by Thiamidol Results in Significant Improvement of Mild to Moderate Melasma. (PubMed)

Effective Tyrosinase Inhibition by Thiamidol Results in Significant Improvement of Mild to Moderate Melasma. Melasma is a pigmentary disorder characterized by hyperpigmented patchy skin in sun-exposed areas, especially the face. Treatment of melasma can be challenging since long-term therapy is required, reoccurrence is common and existing therapies are insufficient and unsatisfactory. To investigate new treatment options, we performed an exploratory double-blinded, randomized split-face study (...) to assess the efficacy of the tyrosinase inhibitor Thiamidol compared to hydroquinone in women with mild to moderate melasma. After 12 weeks, modified melasma area and severity index (mMASI) scores significantly improved on both the Thiamidol-treated and the hydroquinone-treated sides of the face. Additionally, Thiamidol treatment improved mMASI scores significantly better than hydroquinone, and more subjects improved following treatment with Thiamidol (79%) compared with hydroquinone (61%). During

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2019 Journal of Investigative Dermatology Controlled trial quality: uncertain

11. Laser and Laser Compound Therapy for Melasma: A Meta-Analysis. (PubMed)

Laser and Laser Compound Therapy for Melasma: A Meta-Analysis. Treatment of melasma is challenging because its pathogenesis is unclear and it is prone to recurrence. We performed a meta-analysis to evaluate the efficacy and safety of laser and laser compound therapy for melasma.We searched the Cochrane, Embase, and Medline databases for all relevant studies published from inception to July 2018. All randomized controlled trials of melasma describing treatment with lasers or laser compound (...) -analysis provide evidence that laser and laser compound therapy can improve the area and severity of melasma. Further high-quality clinical studies should be carried out in the future to confirm this conclusion.

2019 Journal of Dermatological Treatment

12. The Management of Melasma on Skin Types V and VI Using Light Emitting Diode Treatment. (PubMed)

The Management of Melasma on Skin Types V and VI Using Light Emitting Diode Treatment. This study investigated light emitting diode (LED) treatment for patients with melasma on darker skin types.Melasma is a common disfiguring skin condition in women which is difficult to treat and is refractory. The cause of melasma remains unclear.In this study, 60 female participants aged between 25 and 60 years, who presented with melasma, were enrolled (n = 39.85). They were purposely assigned to two (...) groups according to their skin types. Both groups received a total of 36 LED light treatments over a period of 9 months.Both subjective and objective results indicated a significant improvement of melasma. Statistical analyses revealed significant improvements in both groups.The results of this study suggest that LED is effective in managing melasma. These results will provide a basis for future therapeutic use of phototherapy to improve melasma.

2019 Photomedicine and laser surgery

13. Clinical and epidemiologic features of melasma: a multicentric cross-sectional study from India. (PubMed)

Clinical and epidemiologic features of melasma: a multicentric cross-sectional study from India. Though melasma is a common skin condition in India, epidemiological studies are few and geographically confined. The present study was designed to gain insights into factors involved in causation and aggravation of melasma, demographic distribution, clinical presentations, and treatment patterns.A cross-sectional multicentric study was conducted in 10 centers distributed across the four regions (...) of India. Data including demographics, personal and family medical history, triggering and aggravating factors, clinical patterns, and details of past treatment regimens were recorded, and severity was estimated using the modified Melasma Area and Severity Index (MASI) score. Data collected by site dermatologists were collated and analyzed.The study evaluated 1,001 patients with melasma from 10 centers. Mean age was 38.02 years. Females dominated (85%). Proportion of males was highest in the east (22.2

2019 International Journal of Dermatology

14. A study of efficacy and safety of high-intensity focused ultrasound for the treatment of melasma in Asians: A single-blinded, randomized, split-face, pilot study. (PubMed)

A study of efficacy and safety of high-intensity focused ultrasound for the treatment of melasma in Asians: A single-blinded, randomized, split-face, pilot study. A recent report suggested potential of high-intensity focused ultrasound in improving UVB-induced hyperpigmentation in patients with Fitzpatrick skin type IV, but reports regarding its efficacy in other hyperpigmented conditions including melasma are lacking.To investigate efficacy and safety of high-intensity focused ultrasound (...) for the treatment of melasma in Asians.Each side of the face of 25 melasma patients was randomized to receive 3-monthly sessions of high-intensity focused ultrasound treatment or serve as control. Lightness index, Melasma Area and Severity Index of malar area (MASIm ) by blinded dermatologists, self-evaluated improvement and satisfaction scales by patients, and side effects were assessed every 4 weeks for 20 weeks.Twenty-one patients with Fitzpatrick skin type III and IV completed the study. There was a greater

2019 Journal of cosmetic dermatology Controlled trial quality: uncertain

15. Comparing the efficacy of Myjet-assisted tranexamic acid and vitamin C in treating melasma: A split-face controlled trial. (PubMed)

Comparing the efficacy of Myjet-assisted tranexamic acid and vitamin C in treating melasma: A split-face controlled trial. Melasma is a benign and chronic hypermelanosis characterized by irregular light brown to dark brown patches of hyperpigmentation on the skin. Oral tranexamic acid (TA) or vitamin C (VC) supplementation has been one treatment choice. TA interferes with keratinocyte-melanocyte interactions, and VC functions by reducing melanin production resulting in skin rejuvenation (...) value < 0.05). The difference in efficacy between TA and VC group was not statistically significant (P value 0.05). Both treatments were well tolerated, with no serious adverse events reported.Weekly TA or VC transdermal injections can be an effective treatment for melasma. Further studies are required to validate these findings.© 2019 Wiley Periodicals, Inc.

2019 Journal of cosmetic dermatology Controlled trial quality: uncertain

16. Combination of Oral Tranexamic Acid with Topical 3% Tranexamic Acid versus Oral Tranexamic Acid with Topical 20% Azelaic Acid in the Treatment of Melasma. (PubMed)

Combination of Oral Tranexamic Acid with Topical 3% Tranexamic Acid versus Oral Tranexamic Acid with Topical 20% Azelaic Acid in the Treatment of Melasma. To compare the effect of combination therapies of topical 3% tranexamic acid versus topical 20% azelaic acid each combined with oral tranexamic acid in the treatment of melasma.Interventional comparative study.Department of Dermatology, Sheikh Zayed Hospital, Rahim Yar Khan, from July 2017 to June 2018.Cases of melasma diagnosed clinically (...) is significantly better than oral tranexamic acid with 20% azelaic acid for treatment of melasma.

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2019 Journal of the College of Physicians and Surgeons--Pakistan : JCPSP Controlled trial quality: uncertain

17. A Randomized Controlled Study Comparing the Efficacy of Topical 5% Tranexamic Acid Solution versus 3% Hydroquinone Cream in Melasma. (PubMed)

A Randomized Controlled Study Comparing the Efficacy of Topical 5% Tranexamic Acid Solution versus 3% Hydroquinone Cream in Melasma. Melasma is a common, relapsing, acquired, symmetrical facial hypermelanosis with no universally effective therapy. Hydroquinone (HQ) is considered the gold standard in the treatment of melasma till date. Tranexamic acid (TA) is an upcoming molecule being explored in melasma therapy and has shown optimistic results in preliminary trials. This study aimed to compare (...) the efficacy of topical 5% TA solution with 3% HQ cream in the treatment of melasma in Indian skin.This was a prospective, randomized, single-blind study of 12 weeks' duration. Hundred eligible patients randomly divided into two intervention groups were analyzed after screening 346 patients with melasma. Serial photographs, Melasma Area Severity Index (MASI), and adverse effects were documented at monthly intervals. Patient satisfaction score was noted at the end of 12 weeks. A repeated measurement

2019 Journal of cutaneous and aesthetic surgery Controlled trial quality: uncertain

18. The efficacy and safety of topical 5% methimazole vs 4% hydroquinone in the treatment of melasma: A randomized controlled trial. (PubMed)

The efficacy and safety of topical 5% methimazole vs 4% hydroquinone in the treatment of melasma: A randomized controlled trial. The management of melasma is still challenging, and new treatment modalities with favorable side effect profile are required. Methimazole, a peroxidase inhibitor, seems to have a beneficial effect in the management of melasma but there is a paucity of studies for evaluation of its efficacy. This double-blinded trial was aimed to evaluate the efficacy and safety (...) of methimazole vs hydroquinone 4% which is the gold standard treatment in the management of melasma.Fifty patients with melasma were enrolled and randomly divided into two groups to receive 4% hydroquinone or 5% methimazole once daily for 8 weeks. Forty patients completed the study. The clinical response was assessed at 4th, 8th, and 12th weeks after treatment by MASI score, patient satisfaction, and physician scores.Both groups showed a reduction in the MASI score at the 8th week which was more significant

2019 Journal of cosmetic dermatology Controlled trial quality: uncertain

19. JAAD Game Changers: Randomized, placebo-controlled, double-blind study of oral tranexamic acid in the treatment of moderate-to-severe melasma. (PubMed)

JAAD Game Changers: Randomized, placebo-controlled, double-blind study of oral tranexamic acid in the treatment of moderate-to-severe melasma. 31279026 2019 11 13 1097-6787 81 6 2019 Dec Journal of the American Academy of Dermatology J. Am. Acad. Dermatol. JAAD Game Changers: Randomized, placebo-controlled, double-blind study of oral tranexamic acid in the treatment of moderate-to-severe melasma. 1458 S0190-9622(19)32294-7 10.1016/j.jaad.2019.06.1295 Wohltmann Wendi W San Antonio, Texas

2019 Journal of the American Academy of Dermatology Controlled trial quality: uncertain

20. A cream of herbal mixture to improve melasma. (PubMed)

A cream of herbal mixture to improve melasma. Melasma is an acquired, common hyperpigmented disorder on the face. While many therapeutic approaches are available, their efficacy is moderate.To investigate the safety and efficacy of a cream containing herbal mixture for melasma.A total of 90 volunteers with melasma were enrolled in this randomized, double-blind, controlled clinical study, and they were randomly divided into three groups (A, B, and C). Patients in group A were treated (...) with a cream containing herbal mixture, while groups B and C were treated with arbutin cream and placebo, respectively, twice daily for 12 weeks. Melasma area and severity index (MASI) score, melanin index (MI), erythema index (EI), changes in density of inflammatory cells, and adverse events were evaluated every 4 weeks.Although MASI scores declined significantly in both groups A and B (P < 0.05), a greater reduction was seen in group A (13.00-9.82 = 3.18 for group A; 12.65-10.84 = 1.81 for group B

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2019 Journal of cosmetic dermatology Controlled trial quality: uncertain

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