Melasma: Comparison of Efficacy and Side Effects of Different Treatment Modalities. Literature Review

Abstract

Melasma is a skin disease with different factors contributing to its pathogenesis and development. One causative factor that is heavily involved is chronic sun and UV-radiation exposure. Many different treatment agents and modalities are available for treating melasma skin and reducing the appearance of the lesions, but unfortunately melasma is difficult to treat indefinitely and it has a high recurrence rate. Often the results gained during therapy is lost after treatment cessation. Many of the therapy options are still not fully understood and more clinical trials are suggested to be performed for better awareness. There are different routes of treatment options available for melasma therapy and some examples are topical, intradermal, oral as well as laser and light therapies. These can be used on their own or together as part of a combination treatment regimen. Unfortunately, melasma therapy is not entirely without side effects and often times the different medications cause erythema and irritation on the skin and not all of them are recommended for use during pregnancy and breastfeeding. However, side effects are explained to be dose and duration dependent and there are many options that are well tolerated by patients. There is room for more clinical trials and studies regarding melasma for both better understanding of its development, as well as comparing and evaluating more treatment options or better understanding what is already known and available. The goal would be persistent and long lasting, preferably permanent therapy outcomes even after treatment cessation.