Journal of Infectious Diseases & Therapy
Open Access

Abstract

Background & Aim: Melasma is a common disorder of pigmentation affecting people with darker skin types, most commonly Fitzpatrick skin types III-IV. Despite the large variety of treatment options available including solar exposure prevention, topical lightening agents, chemical peels, light-based and laser therapies, none have shown effective and sustained results, making melasma a challenging and difficult-to-treat condition. Recently, there has been increasing interest in systemic medications in the treatment of melasma. This systematic review evaluates the current state of evidence of these systemic medications in terms of efficacy and safety/ tolerability in the treatment of melasma. Methods: Multiple databases were systematically searched for randomized clinical trials (RCTs) evaluating the use of systemic medications for the treatment of melasma. A study was excluded if it did not satisfy RCT requirements, did not include melasma patients, did not report melasma specific outcome measures or consisted of fewer than 10 subjects. Results: Initial search yielded 629 papers evaluating a variety of treatments for melasma.After the application of inclusion and exclusion criteria, a total of 8 studies met eligibility criteria. Systemic medications evaluated include tranexamic acid (TA), Polypodium leucotomos extract (PLE), beta-carotenoid, melatonin and procyanidin. These agents have a generally beneficial effect with a minimal number and severity of adverse effects. Conclusion: Oral medications have been shown to be efficacious, safe and well-tolerated in the treatment of melasma. We recommend that dermatologists introduce systematic medications to their armamentarium for the treatment of melasma.

Biography

Email: lzhou026@uottawa.ca