PATHOPHYSIOLOGICAL INSIGHTS INTO FACIAL HYPERPIGMENTATION AND AESTHETIC TREATMENT MODALITIES

Anti-Aging Eastern Europe, Journal Year: 2025, Volume and Issue: 4(1), P. 14 - 19

Published: April 2, 2025

Facial hyperpigmentation, including melasma and post-inflammatory poses a significant dermatological psychosocial challenge. These conditions arise from complex interplay of genetic factors, hormonal influences, environmental exposures (UV, VL, IR), with management particularly challenging in skin color. This narrative review synthesizes current insights into the pathophysiology hyperpigmentation—emphasizing roles MC1R, tyrosinase, related enzymes melanogenesis—and evaluates both established emerging treatment modalities. A systematic literature search up to February 2025 identified studies addressing topical, oral, laser, combination therapies. Topical treatments, such as 5% alpha-arbutin 2% kojic acid cream, demonstrated efficacy comparable triple formulations but lower recurrence (p = 0.004). Low-dose tranexamic acid, delivered orally or via mesotherapy, significantly reduced modified Melasma Area Severity Index (mMASI) scores 0.02) improved quality life 0.03). Laser therapies—including picosecond Nd:YAG 755-nm lasers—produced mMASI reductions < 0.001), nonablative 1,927-nm fractional laser achieving 43% improvement pigmentation among darker types 0.0001). Adjunctive procedures, glycolic peels, supramolecular salicylic niacinamide, microneedling, further enhanced clinical outcomes 0.05–p 0.001). Preliminary evidence also supports acupuncture promising complementary approach. In summary, an individualized, multimodal strategy is essential for optimal facial hyperpigmentation. Further controlled are warranted refine these protocols enhance long-term therapeutic efficacy.

Language: Английский

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Efficacy and Safety of Nicotinamide 10%, Associated with Magnesium Ascorbyl Phosphate 5% and Hyaluronic Acid 5%, Compared to Hydroquinone 4% in Women with Facial Melasma: A Randomized, Double-Blind, Controlled Clinical Trial.

Clinical Cosmetic and Investigational Dermatology, Journal Year: 2024, Volume and Issue: Volume 17, P. 2215 - 2223

Published: Oct. 1, 2024

Nicotinamide has demonstrated efficacy in the treatment of melasma. Topical antioxidants and humectants may enhance its performance. Currently, there is no controlled trial on combination 10% nicotinamide, 5% magnesium ascorbyl phosphate, hyaluronic acid, a dermo-cosmetic compound, comparison to 4% hydroquinone for This study aimed explore tolerability association combined product

Language: Английский

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Latin American consensus on the treatment of melasma

International Journal of Dermatology, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 16, 2024

Abstract Melasma is a chronic, relapsing hyperpigmentation disorder that primarily affects photoexposed areas, occurring most frequently in adult women with darker skin phototypes. The primary factors contributing to its development include sun exposure, sex hormones (e.g., pregnancy), and genetic predisposition. highly prevalent Latin America, where many countries lie intertropical zones exhibit significant ethnic diversity because of centuries intermixing among Native Americans, Europeans, Sub‐Saharan Africans. Nine American experts formulated DELPHI‐based consensus develop valuable approach for treating melasma this diverse population. After establishing an accurate diagnosis, assessing the impact on quality life, determining disease severity, recommends mitigating known triggers promoting rigorous photoprotection. Active therapy should be tailored based individual characteristics pregnancy status, previous treatments, sensitivity). Treatment options topical depigmenting agents, systemic therapies, procedural interventions such as laser therapy, microneedling, chemical peels. Periodic reassessment treatment essential, strategies adjusted if targeted outcomes are not achieved. Once clinical remission attained, patients continue using agents maintain strict photoprotection measures prevent recurrence.

Language: Английский

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Clinical Efficacy of Cysteamine Application for Melasma: A Meta-Analysis

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(23), P. 7483 - 7483

Published: Dec. 9, 2024

Background: Melasma is a challenging, acquired hyperpigmentary disorder. The gold standard treatment Kligman's formulation, which contains hydroquinone, tretinoin, and dexamethasone, but its long-term use limited by the risk of exogenous ochronosis. Cysteamine, tyrosinase inhibitor, reduces melanocyte activity melanin production, showing strong depigmenting effects in patients resistant to formulation. Nonetheless, clinical studies have yielded inconsistent efficacy results. This meta-analysis aimed assess cysteamine treating melasma identify potential factors that may impact therapeutic outcomes. Methods: A systematic search PubMed, Embase, Web Science, CENTRAL, from earliest record until August 2024, was conducted. Randomized controlled trials quasi-randomized design related topical on were included. primary outcome MASI or mMASI assessment after treatments. current conducted with random-effects model. Subgroup analyses meta-regressions performed based baseline MASI, disease duration melasma, patient age, sample size included studies. Funnel plots Duval Tweedie's trim fill method adopted publication bias. Results: Eight for quantitative analysis. analysis demonstrated significant decrease compared placebo (p = 0.002). Compared other treatments, did not show superior 0.277). modified formula, tranexamic acid mesotherapy statistically different when 0.434). Further showed no benefit allowing extended application time < 0.0001). meta-regression revealed decreased as increased (coefficient 0.38, p 0.0001, R2 0.99). funnel plot displayed some asymmetry. suggested adjusted effect 0.607 (95% CI -0.720 1.935). Conclusions: Cysteamine exhibited patients; however, depigmentation comparable hydroquinone-based regimens, mesotherapy, formula. Using short result better efficacy.

Language: Английский

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