Current Approaches For Melasma Treatment and Possible Toxic Effects

Year 2022, Volume: 42 Issue: 2, 105 - 120, 01.06.2022

Hülya Tezel Aylin Balcı Pınar Erkekoğlu

https://doi.org/10.52794/hujpharm.1005810

Abstract

Melasma is a chronic and localized pigmentation disorder that arises from increased melanin accumulation due to the enhanced number and activity of melanocytes in epidermis and/or dermis. This disorder appears on the parts of face, which are highly exposed to light and seen as hipermelanosis. Even if treated successfully, it can relapse. Most cases of melasma are seen in dark skin-toned (Fitzpatrick skin type IV – VI) and reproductive-aged women who are living in regions with high ultraviolet radiation. However, it is also encountered in different people with every age, race and skin color. Pathogenesis of melasma is complicated and variable and it is thought to occur because of complex interactions between epidermal melanocytes, keratinocytes, dermal fibroblasts, mast cells and vascular endothelial cells. Although some factors like sun exposure, genetic predisposition, pregnancy, oral contraceptive and steroid use, ovary tumors, use of irritant cosmetic products and use of drugs that cause photosensitivity were described for its etiopathogenesis, the accurate cause of malesma is not known. In this review, recent developments in the pathogenesis and treatment of melasma will be summarized, and the efficacy and toxic effects of current and new treatment options will be discussed.

Keywords

hyperpigmentation, melasma, hydroquinone, laser, depigmentation

Melazma Tedavisinde Güncel Yaklaşımlar Ve Olası Toksik Etkileri

Abstract

Melazma epidermiste melanosit sayısının ve aktivitesinin artmasına bağlı olarak epidermis ve/veya dermiste artan melanin birikimiyle çıkan bir kronik ve lokalize pigmentasyon bozukluğudur. Bu bozukluk sıklıkla da yüzün güneşe maruz kalan bölgelerinde görülür ve hipermelanoz şeklinde kendini gösterir. Başarılı bir şekilde tedavi edilse dahi tekrarlayabilir. Melazma vakalarının çoğu, yüksek ultraviyole radyasyonun olduğu bölgelerde yaşayan daha koyu ten rengi tonlarına sahip (Fitzpatrick cilt tipi IV – VI) üreme çağındaki kadınlarda görülür. Ancak, her yaştan, ırktan ve ten renginden insanda da görülebilir. Epidermal melanositler, keratinositler, dermal fibroblastlar, mast hücreleri ve vasküler endotelyal hücreler arasında karmaşık etkileşimler sonucunda oluştuğu düşünüldüğünden, melazmanın patogenezi komplike ve değişkendir. Etiyopatogenezinde güneşe maruz kalma, genetik yatkınlık, gebelik, oral kontraseptif ve steroid kullanımı, yumurtalık tümörleri, irritan kozmetik ürünlerin kullanımı ve fotoduyarlılığa sebep olan ilaçların kullanımı gibi bazı faktörler tanımlanmasına rağmen, melazmanın kesin nedeni tam olarak bilinmemektedir. Bu derlemede melazmanın patogenezindeki ve tedavisindeki en son gelişmeler hakkındaki bilgiler özetlenecek, mevcut ve yeni tedavi seçeneklerinin etkinlikleri ve toksik etkileri tartışılacaktır.

Keywords

hiperpigmentasyon, melazma, hidrokinon, lazer, depigmentasyon

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