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American Journal of Clinical Dermatology

Erschienen in:

04.12.2019 | Systematic Review

Melasma Treatment: An Evidence-Based Review

verfasst von: Jacqueline McKesey, Andrea Tovar-Garza, Amit G. Pandya

Erschienen in: American Journal of Clinical Dermatology | Ausgabe 2/2020

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Abstract

Background

Melasma is an acquired, chronic pigmentary disorder predominantly affecting women. It may significantly affect quality of life and self-esteem due to its disfiguring appearance. Multiple treatments for melasma are available, with mixed results.

Objective

The aim of this article was to conduct an evidence-based review of all available interventions for melasma.

Methods

A systematic literature search of the PubMed electronic database was performed using the keywords ‘melasma’ and/or ‘chloasma’ in the title, through October 2018. The search was then limited to ‘randomized controlled trial’ and ‘controlled clinical trial’ in English-language journals. The Cochrane database was also searched for systematic reviews.

Results

The electronic search yielded a total of 212 citations. Overall, 113 studies met the inclusion criteria and were included in this review, with a total of 6897 participants. Interventions included topical agents, chemical peels, laser- and light-based devices, and oral agents. Triple combination cream (hydroquinone, tretinoin, and corticosteroid) remains the most effective treatment for melasma, as well as hydroquinone alone. Chemical peels and laser- and light-based devices have mixed results. Oral tranexamic acid is a promising new treatment for moderate and severe recurrent melasma. Adverse events from all treatments tend to be mild, and mainly consist of skin irritation, dryness, burning, erythema, and post-inflammatory hyperpigmentation.

Conclusions

Hydroquinone monotherapy and triple combination cream are the most effective and well-studied treatments for melasma, whereas chemical peels and laser- and light-based therapies are equal or inferior to topicals, but offer a higher risk of adverse effects. Oral tranexamic acid may be a safe, systemic adjunctive treatment for melasma, but more studies are needed to determine its long-term safety and efficacy. Limitations of the current evidence are heterogeneity of study design, small sample size, and lack of long-term follow-up, highlighting the need for larger, more rigorous studies in the treatment of this recalcitrant disorder.

Jiang J, Akinseye O, Tovar-Garza A, Pandya AG. The effect of melasma on self-esteem: a pilot study. Int J Womens Dermatol. 2017;4(1):38–42.PubMedPubMedCentral

Grimes PE. Melasma: etiologic and therapeutic considerations. Arch Dermatol. 1995;131:1453–7.PubMed

Ortonne JP, Arellano I, Berneburg M, et al. A global survey of the role of ultraviolet radiation and hormonal influences in the development of melasma. J Eur Acad Dermatol Venereol. 2009;23:1254–62.PubMed

Pathak MA, Riley FC, Fitzpatrick TB. Melanogenesis in human skin following exposure to long ultraviolet and visible light. J Investig Dermatol. 1962;39:435.PubMed

Sanchez NP, Pathak MA, Sato S. Melasma: a clinical, light microscopic, ultrastructural, and immunofluorescence study. J Am Acad Dermatol. 1981;4:698–709.PubMed

Resnik S. Melasma induced by oral contraceptive drugs. JAMA. 1967;199:601–5.PubMed

Ponzio HA, Favaretto AL, Rivitti EA. Proposal of a quantitative method to describe melasma distribution in women. J Cosmet Dermatol. 2007;20:103–11.

Rajaratnam R, Halpern J, Salim A, Emmett C. Interventions for melasma. Cochrane Database Syst Rev. 2010;7(7):CD003583.

Draelos ZD. Skin lightening preparations and the hydroquinone controversy. Dermatol Ther. 2007;20(5):308–13.PubMed

10.

Westerhof W, Kooyers TJ. Hydroquinone and its analogues in dermatology—a potential health risk. J Cosmet Dermatol. 2005;4(2):55–9.PubMed

11.

Nordlund JJ, Grimes PE, Ortonne JP. The safety of hydroquinone. J Eur Acad Dermatol Venereol. 2006;20(7):781–7.PubMed

12.

Ennes SBP, Paschoalick RC, De Avelar Alchorne MM. A double-blind comparative placebo-controlled study of the efficacy and tolerability of 4% hydroquinone as a depigmenting agent in melasma. J Dermatol Treat. 2000;11:173–9.

13.

Vázquez M, Sánchez JL. The efficacy of a broad-spectrum sunscreen in the treatment of melasma. Cutis. 1983;32(1):92 (95–96).PubMed

14.

Verallo-Rowell VM, Verallo V, Graupe K, Lopez-Villafuerte L, Garcia-Lopez M. Double-blind comparison of azelaic acid and hydroquinone in the treatment of melasma. Acta Derm Venereol Suppl (Stockh). 1989;143:58–61.PubMed

15.

Sivayathorn A, Verallo-Rowell V, Graupe K. 20% azelaic acid cream in the topical treatment of melasma: a double-blind comparison with 2% hydroquinone. Eur J Dermatol. 1995;5:680–4.

16.

Baliña LM, Graupe K. The treatment of melasma. 20% azelaic acid versus 4% hydroquinone cream. Int J Dermatol. 1991;30(12):893–5.PubMed

17.

Farshi S. Comparative study of therapeutic effects of 20% azelaic acid and hydroquinone 4% cream in the treatment of melasma. J Cosmet Dermatol. 2011;10(4):282–7.PubMed

18.

Sarkar R, Bhalla M, Kanwar AJ. A comparative study of 20% azelaic acid cream monotherapy versus a sequential therapy in the treatment of melasma in dark-skinned patients. Dermatology. 2002;205(3):249–54.PubMed

19.

Huh CH, Seo KI, Park JY, Lim JG, Eun HC, Park KC. A randomized, double-blind, placebo-controlled trial of vitamin C iontophoresis in melasma. Dermatology. 2003;206(4):316–20.PubMed

20.

Espinal-Perez LE, Moncada B, Castanedo-Cazares JP. A double-blind randomized trial of 5% ascorbic acid vs. 4% hydroquinone in melasma. Int J Dermatol. 2004;43(8):604–7.PubMed

21.

Khemis A, Kaiafa A, Queille-Roussel C, Duteil L, Ortonne JP. Evaluation of efficacy and safety of rucinol serum in patients with melasma: a randomized controlled trial. Br J Dermatol. 2007;156(5):997–1004.PubMed

22.

Huh SY, Shin JW, Na JI, Huh CH, Youn SW, Park KC. Efficacy and safety of liposome-encapsulated 4-n-butylresorcinol 0.1% cream for the treatment of melasma: a randomized controlled split-face trial. J Dermatol. 2010;37(4):311–5.PubMed

23.

Romero C, Aberdam E, Larnier C, Ortonne JP. Retinoic acid as modulator of UVB-induced melanocyte differentiation. Involvement of the melanogenic enzyme’s expression. J Cell Sci. 1994;107:1095–103.PubMed

24.

Ortonne JP. Retinoid therapy of pigmented disorders. Dermatol Ther. 2006;19:280–8.PubMed

25.

Griffiths CE, Finkel LJ, Ditre CM, Hamilton TA, Ellis CN, Voorhees JJ. Topical tretinoin (retinoic acid) improves melasma. A vehicle-controlled, clinical trial. Br J Dermatol. 1993;129(4):415–21.PubMed

26.

Kimbrough-Green CK, Griffiths CE, Finkel LJ, Hamilton TA, Bulengo-Ransby SM, Ellis CN, Voorhees JJ. Topical retinoic acid (tretinoin) for melasma in black patients. A vehicle-controlled clinical trial. Arch Dermatol. 1994;130(6):727–33.PubMed

27.

Leenutaphong V, Nettakul A, Rattanasuwon P. Topical isotretinoin for melasma in Thai patients: a vehicle-controlled clinical trial. J Med Assoc Thai. 1999;82(9):868–75.PubMed

28.

Dogra S, Kanwar AJ, Parsad D. Adapalene in the treatment of melasma: a preliminary report. J Dermatol. 2002;29(8):539–40.PubMed

29.

Truchuelo MT, Jiménez N, Jaén P. Assessment of the efficacy and tolerance of a new combination of retinoids and depigmenting agents in the treatment of melasma. J Cosmet Dermatol. 2014;13(4):261–8.PubMed

30.

Liebel F, Kaur S, Ruvolo E, Kollias N, Southall MD. Irradiation of skin with visible light induces reactive oxygen species and matrix-degrading enzymes. J Investig Dermatol. 2012;132:1901–7.PubMed

31.

Mahmoud BH, Ruvolo E, Hexsel CL, et al. Impact of long-wavelength UVA and visible light on melanocompetent skin. J Investig Dermatol. 2010;130:2092–7.PubMed

32.

Castanedo-Cazares JP, Hernandez-Blanco D, Carlos-Ortega B, Fuentes-Ahumada C, Torres-Álvarez B. Near-visible light and UV photoprotection in the treatment of melasma: a double-blind randomized trial. Photodermatol Photoimmunol Photomed. 2014;30(1):35–42.PubMed

33.

Yousefi A, Khani Khoozani Z, Zakerzadeh Forooshani S, Omrani N, Moini AM, Eskandari Y. Is topical zinc effective in the treatment of melasma? A double-blind randomized comparative study. Dermatol Surg. 2014;40(1):33–7.PubMed

34.

Ebrahimi B, Naeini FF. Topical tranexamic acid as a promising treatment for melasma. J Res Med Sci. 2014;19(8):753–7.PubMedPubMedCentral

35.

Banihashemi M, Zabolinejad N, Jaafari MR, Salehi M, Jabari A. Comparison of therapeutic effects of liposomal Tranexamic Acid and conventional Hydroquinone on melasma. J Cosmet Dermatol. 2015;14(3):174–7.PubMed

36.

Atefi N, Dalvand B, Ghassemi M, Mehran G, Heydarian A. Therapeutic effects of topical tranexamic acid in comparison with hydroquinone in treatment of women with Melasma. Dermatol Ther (Heidelb). 2017;7(3):417–24.PubMedPubMedCentral

37.

Laothaworn V, Juntongjin P. Topical 3% tranexamic acid enhances the efficacy of 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser in the treatment of melasma. J Cosmet Laser Ther. 2018;20(6):320–5.PubMed

38.

Xu Y, Ma R, Juliandri J, Wang X, Xu B, Wang D, Lu Y, Zhou B, Luo D. Efficacy of functional microarray of microneedles combined with topical tranexamic acid for melasma: a randomized, self-controlled, split-face study. Medicine (Baltimore). 2017;96(19):e6897.PubMedPubMedCentral

39.

Saki N, Darayesh M, Heiran A. Comparing the efficacy of topical hydroquinone 2% versus intradermal tranexamic acid microinjections in treating melasma: a split-face controlled trial. J Dermatol Treat. 2018;29(4):405–10.

40.

Tehranchinia Z, Saghi B, Rahimi H. Evaluation of therapeutic efficacy and safety of tranexamic acid local infiltration in combination with topical 4% hydroquinone cream compared to topical 4% hydroquinone cream alone in patients with melasma: a split-face study. Dermatol Res Pract. 2018;2018:8350317.PubMedPubMedCentral

41.

Steiner D, Feola C, Bialeski N, Ayeres de Morais e Silva F, César Pessanha Antiori A, Alvim Sant’Anna Addor F, Brandão Folino B. Study evaluating the efficacy of topical and injected tranexamic acid in treatment of melasma. Surg Cosmet Dermatol. 2009;1(4):174–7.

42.

Budamakuntla L, Loganathan E, Suresh DH, Shanmugam S, Suryanarayan S, Dongare A, Venkataramiah LD, Prabhu N. A randomised, open-label, comparative study of tranexamic acid microinjections and tranexamic acid with microneedling in patients with Melasma. J Cutan Aesthet Surg. 2013;6(3):139–43.PubMedPubMedCentral

43.

Taylor SC, Torok H, Jones T, Lowe N, Rich P, Tschen E, Menter A, Baumann L, Wieder JJ, Jarratt MM, Pariser D, Martin D, Weiss J, Shavin J, Ramirez N. Efficacy and safety of a new triple-combination agent for the treatment of facial melasma. Cutis. 2003;72(1):67–72.PubMed

44.

Torok H, Taylor S, Baumann L, Jones T, Wieder J, Lowe N, Jarret M, Rich P, Pariser D, Tschen E, Martin D, Menter A, Weiss J. A large 12-month extension study of an 8-week trial to evaluate the safety and efficacy of triple combination (TC) cream in melasma patients previously treated with TC cream or one of its dyads. J Drugs Dermatol. 2005;4(5):592–7.PubMed

45.

Ferreira Cestari T, Hassun K, Sittart A, de Lourdes Viegas M. A comparison of triple combination cream and hydroquinone 4% cream for the treatment of moderate to severe facial melasma. J Cosmet Dermatol. 2007;6(1):36–9.PubMed

46.

Chan R, Park KC, Lee MH, Lee ES, Chang SE, Leow YH, Tay YK, Legarda-Montinola F, Tsai RY, Tsai TH, Shek S, Kerrouche N, Thomas G, Verallo-Rowell V. A randomized controlled trial of the efficacy and safety of a fixed triple combination (fluocinolone acetonide 0.01%, hydroquinone 4%, tretinoin 0.05%) compared with hydroquinone 4% cream in Asian patients with moderate to severe melasma. Br J Dermatol. 2008;159(3):697–703.PubMed

47.

Gong Z, Lai W, Zhao G, Wang X, Zheng M, Li L, Yang Q, Dang Y, Liu L, Zou Y. Efficacy and safety of fluocinolone acetonide, hydroquinone, and tretinoin cream in Chinese patients with melasma: a randomized, double-blind, placebo-controlled, multicenter, parallel-group study. Clin Drug Investig. 2015;35(6):385–95.PubMed

48.

Arellano I, Cestari T, Ocampo-Candiani J, Azulay-Abulafia L, Bezerra Trindade Neto P, Hexsel D, Machado-Pinto J, Muñoz H, Rivitti-Machado MC, Sittart JA, Trindade de Almeida AR, Rego V, Paliargues F, Marques-Hassun K. Preventing melasma recurrence: prescribing a maintenance regimen with an effective triple combination cream based on long-standing clinical severity. J Eur Acad Dermatol Venereol. 2012;26(5):611–8.PubMed

49.

Grimes PE, Bhawan J, Guevara IL, Colón LE, Johnson LA, Gottschalk RW, Pandya AG. Continuous therapy followed by a maintenance therapy regimen with a triple combination cream for melasma. J Am Acad Dermatol. 2010;62(6):962–7.PubMed

50.

Guevara IL, Pandya AG. Safety and efficacy of 4% hydroquinone combined with 10% glycolic acid, antioxidants, and sunscreen in the treatment of melasma. Int J Dermatol. 2003;42(12):966–72.PubMed

51.

Lim JT. Treatment of melasma using kojic acid in a gel containing hydroquinone and glycolic acid. Dermatol Surg. 1999;25(4):282–4.PubMed

52.

Haddad AL, Matos LF, Brunstein F, Ferreira LM, Silva A, Costa D Jr. A clinical, prospective, randomized, double-blind trial comparing skin whitening complex with hydroquinone vs. placebo in the treatment of melasma. Int J Dermatol. 2003;42(2):153–6.PubMed

53.

Francisco-Diaz J, Cristi-Cataluna I, Cruz DD, Verallo-Rowell VM. A double-blind randomized placebo-controlled trial on the efficacy and safety of botanical extract (Gigawhite_ 5% solution) in the treatment of melasma. J Philos Dermatol Soc. 2004;13:18–23.

54.

Thirion L, Pierard-Franchimont C, Pierard G. Whitening effect of a dermocosmetic formulation: a randomized double-blind controlled study on melasma. Int J Cosmet Sci. 2006;28:263–7.PubMed

55.

Makino ET, Mehta RC, Garruto J, Gotz V, Sigler ML, Herndon JH. Clinical efficacy and safety of a multimodality skin brightener composition compared with 4% hydroquinone. J Drugs Dermatol. 2013;12(3):s21–6.PubMed

56.

Monheit GD, Dreher F. Comparison of a skin-lightening cream targeting melanogenesis on multiple levels to triple combination cream for melasma. J Drugs Dermatol. 2013;12(3):270–4.PubMed

57.

Wanner M, Houston N, Javorsky E, Yuan M, Alora-Palli M, Kimball AB. Single blind, randomized, controlled trial of a lightening product with and without iontophoresis versus tretinoin and vehicle for hyperpigmentation. J Drugs Dermatol. 2015;14(1):13–8.PubMed

58.

Pratchyapurit WO. Combined use of two formulations containing diacetyl boldine, TGF-β1 biomimetic oligopeptide-68 with other hypopigmenting/exfoliating agents and sunscreen provides effective and convenient treatment for facial melasma. Either is equal to or is better than 4% hydroquinone on normal skin. J Cosmet Dermatol. 2016;15(2):131–44.PubMed

59.

Amer M, Metwalli M. Topical liquiritin improves melasma. Int J Dermatol. 2000;39(4):299–301.PubMed

60.

Costa A, Moisés TA, Cordero T, Alves CR, Marmirori J. Association of emblica, licorice and belides as an alternative to hydroquinone in the clinical treatment of melasma. An Bras Dermatol. 2010;85(5):613–20.PubMed

61.

Morag M, Nawrot J, Siatkowski I, Adamski Z, Fedorowicz T, Dawid-Pac R, Urbanska M, Nowak G. A double-blind, placebo-controlled randomized trial of Serratulae quinquefoliae folium, a new source of β-arbutin, in selected skin hyperpigmentation. J Cosmet Dermatol. 2015;14(3):185–90.PubMed

62.

Alvin G, Catambay N, Vergara A, Jamora MJ. A comparative study of the safety and efficacy of 75% mulberry (Morus alba) extract oil versus placebo as a topical treatment for melasma: a randomized, single-blind, placebo-controlled trial. J Drugs Dermatol. 2011;10(9):1025–31.PubMed

63.

Draelos ZD. A split-face evaluation of a novel pigment-lightening agent compared with no treatment and hydroquinone [published erratum in J Am Acad Dermatol. 2015;72(6):1096]. J Am Acad Dermatol. 2015;72(1):105–7.PubMed

64.

Khosravan S, Alami A, Mohammadzadeh-Moghadam H, Ramezani V. The effect of topical use of Petroselinum crispum (Parsley) versus that of hydroquinone cream on reduction of epidermal melasma: a randomized clinical trial. Holist Nurs Pract. 2017;31(1):16–20.PubMed

65.

Mendoza CG, Singzon IA, Handog EB. A randomized, double-blind, placebo-controlled clinical trial on the efficacy and safety of 3% Rumex occidentalis cream versus 4% hydroquinone cream in the treatment of melasma among Filipinos. Int J Dermatol. 2014;53(11):1412–6.PubMed

66.

Altaei T. The treatment of melasma by silymarin cream. BMC Dermatol. 2012;12:18.PubMedPubMedCentral

67.

Lee MH, Kim HJ, Ha DJ, Paik JH, Kim HY. Therapeutic effect of topical application of linoleic acid and lincomycin in combination with betamethasone valerate in melasma patients. J Korean Med Sci. 2002;17(4):518–23.PubMedPubMedCentral

68.

Katoulis A, Alevizou A, Soura E, Mantas N, Bozi E, Gregoriou S, Makris M, Rigopoulos D. A double-blind vehicle-controlled study of a preparation containing undecylenoyl phenylalanine 2% in the treatment of melasma in females. J Cosmet Dermatol. 2014;13(2):86–90.PubMed

69.

Mansouri P, Farshi S, Hashemi Z, Kasraee B. Evaluation of the efficacy of cysteamine 5% cream in the treatment of epidermal melasma: a randomized double-blind placebo-controlled trial. Br J Dermatol. 2015;173(1):209–17.PubMed

70.

Farshi S, Mansouri P, Kasraee B. Efficacy of cysteamine cream in the treatment of epidermal melasma, evaluating by Dermacatch as a new measurement method: a randomized double blind placebo controlled study. J Dermatol Treat. 2018;29(2):182–9.

71.

Adalatkhah H, Sadeghi-Bazargani H. The first clinical experience on efficacy of topical flutamide on melasma compared with topical hydroquinone: a randomized clinical trial. Drug Des Dev Ther. 2015;9:4219–25.

72.

Eshghi G, Khezrian L, Esna Ashari F. Comparison between intralesional triamcinolone and Kligman’s formula in treatment of melasma. Acta Med Iran. 2016;54(1):67–71.PubMed

73.

Lim JT, Tham SN. Glycolic acid peels in the treatment of melasma among Asian women. Dermatol Surg. 1997;23(3):177–9.PubMed

74.

Hurley ME, Guevara IL, Gonzales RM, Pandya AG. Efficacy of glycolic acid peels in the treatment of melasma. Arch Dermatol. 2002;138:1578–82.PubMed

75.

Ilknur T, Biçak MÜ, Demirtaşoğlu M, Özkan Ş. Glycolic acid peels versus amino fruit acid peels in the treatment of melasma. Dermatol Surg. 2010;36(4):490–5.PubMed

76.

Kumari R, Thappa DM. Comparative study of trichloroacetic acid versus glycolic acid chemical peels in the treatment of melasma. Indian J Dermatol Venereol Leprol. 2010;76(4):447.PubMed

77.

Faghihi G, Shahingohar A, Siadat AH. Comparison between 1% tretinoin peeling versus 70% glycolic acid peeling in the treatment of female patients with melasma. J Drugs Dermatol. 2011;10(12):1439–42.PubMed

78.

Sarkar R, Kaur C, Bhalla M, Kanwar AJ. The combination of glycolic acid peels with a topical regimen in the treatment of melasma in dark-skinned patients: a comparative study. Dermatol Surg. 2002;28(9):828–32.PubMed

79.

Erbil H, Sezer E, Taştan B, Arca E, Kurumlu Z. Efficacy and safety of serial glycolic acid peels and a topical regimen in the treatment of recalcitrant melasma. J Dermatol. 2007;34(1):25–30.PubMed

80.

Dayal S, Sahu P, Dua R. Combination of glycolic acid peel and topical 20% azelaic acid cream in melasma patients: efficacy and improvement in quality of life. J Cosmet Dermatol. 2017;16(1):35–42.PubMed

81.

Sarkar R, Garg V, Bansal S, Sethi S, Gupta C. Comparative evaluation of efficacy and tolerability of glycolic acid, salicylic mandelic acid, and phytic acid combination peels in melasma. Dermatol Surg. 2016;42(3):384–91.PubMed

82.

Ejaz A, Raza N, Iftikhar N, Muzzafar F. Comparison of 30% salicylic acid with Jessner’s solution for superficial chemical peeling in epidermal melasma. J Coll Phys Surg Pak. 2008;18(4):205–8.

83.

Kodali S, Guevara IL, Carrigan CR, Daulat S, Blanco G, Boker A, Hynan LS, Pandya AG. A prospective, randomized, split-face, controlled trial of salicylic acid peels in the treatment of melasma in Latin American women. J Am Acad Dermatol. 2010;63(6):1030–5.PubMed

84.

Balevi A, Ustuner P, Özdemir M. Salicylic acid peeling combined with vitamin C mesotherapy versus salicylic acid peeling alone in the treatment of mixed type melasma: a comparative study. J Cosmet Laser Ther. 2017;19(5):294–9.PubMed

85.

Azzam OA, Leheta TM, Nagui NA, Shaarawy E, Hay RM, Hilal RF. Different therapeutic modalities for treatment of melasma. J Cosmet Dermatol. 2009;8(4):275–81.PubMed

86.

Murtaza F, Bangash AR, Khushdil A, Noor SM. Efficacy of trichloro-acetic acid peel alone versus combined topical magnesium ascorbyl phosphate for epidermal melasma. J Coll Phys Surg Pak. 2016;26(7):557–61.

87.

Abdel-Meguid AM, Taha EA, Ismail SA. Combined Jessner solution and trichloroacetic acid versus trichloroacetic acid alone in the treatment of melasma in dark-skinned patients. Dermatol Surg. 2017;43(5):651–6.PubMed

88.

Wang CC, Hui CY, Sue YM, Wong WR, Hong HS. Intense pulsed light for the treatment of refractory melasma in Asian persons. Dermatol Surg. 2004;30(9):1196–200.PubMed

89.

Goldman MP, Gold MH, Palm MD, Colon LE, Preston N, Johnson LA, Gottschalk RW. Sequential treatment with triple combination cream and intense pulsed light is more efficacious than sequential treatment with an inactive (control) cream and intense pulsed light in patients with moderate to severe melasma. Dermatol Surg. 2011;37(2):224–33.PubMed

90.

Figueiredo Souza L, Trancoso Souza S. Single-session intense pulsed light combined with stable fixed-dose triple combination topical therapy for the treatment of refractory melasma. Dermatol Ther. 2012;25(5):477–80.PubMed

91.

Chung JY, Lee JH, Lee JH. Topical tranexamic acid as an adjuvant treatment in melasma: side-by-side comparison clinical study. J Dermatol Ther. 2016;27(4):373–7.

92.

Shakeeb N, Noor SM, Ullah G, Paracha MM. Efficacy of intense pulse light therapy and triple combination cream versus intense pulse light therapy and triple combination cream alone in epidermal melasma treatment. J Coll Surg Pak. 2018;28(1):13–6.

93.

Yun WJ, Moon HR, Lee MW, Choi JH, Chang SE. Combination treatment of low-fluence 1,064-nm Q-Switched Nd:YAG laser with novel intense pulse light in Korean melasma patients a prospective, randomized, controlled trial. Dermatol Surg. 2014;40(8):842–50.PubMed

94.

Yun WJ, Lee SM, Han JS, Lee SH, Chang SY, Haw S, Lee JB, Won CH, Lee MW, Choi JH, Chang SE. A prospective, split-face, randomized study of the efficacy and safety of a novel fractionated intense pulsed light treatment for melasma in Asians. J Cosmet Laser Ther. 2015;17(5):259–66.PubMed

95.

Park KY, Kim DH, Kim HK, Li K, Seo SJ, Hong CK. A randomized, observer-blinded, comparison of combined 1064-nm Q-switched neodymium-doped yttrium–aluminum–garnet laser plus 30% glycolic acid peel vs. laser monotherapy to treat melasma. J Clin Exp Dermatol Res. 2011;36(8):864–70.

96.

Lee DB, Suh HS, Choi YS. A comparative study of low-fluence 1,064 nm Q-Switched Nd: YAG laser with or without chemical peeling using Jessner’s solution in melasma patients. J Cosmet Laser Ther. 2014;16(6):264–70.PubMed

97.

Ustuner P, Balevi A, Ozdemir M. A split-face, investigator-blinded comparative study on the efficacy and safety of Q-switched Nd:YAG laser plus microneedling with vitamin C versus Q-switched Nd: YAG laser for the treatment of recalcitrant melasma. J Cosmet Laser Ther. 2017;19(7):383–90.PubMed

98.

Kaminaka C, Furukawa F, Yamamoto Y. The clinical and histological effect of a low-fluence Q-Switched 1,064-nm neodymium:yttrium-aluminum-garnet laser for the treatment of melasma and solar lentigines in asians prospective, randomized, and split-face comparative study. Dermatol Surg. 2017;43(9):1120–33.PubMed

99.

Jeong SY, Shin JB, Yeo UC, Kim WS, Kim IH. Low-fluence Q-switched neodymium-doped yttrium aluminum garnet laser for melasma with pre-or post-treatment triple combination cream. Dermatol Surg. 2010;36(6):909–18.PubMed

100.

Wattanakrai P, Mornchan R, Eimpunth S. Low-fluence Q-switched neodymium-doped yttrium aluminum garnet (1,064 nm) laser for the treatment of facial melasma in Asians. Dermatol Surg. 2010;36(1):76–87.PubMed

101.

Kar HK, Gupta L, Chauhan A. A comparative study on efficacy of high and low fluence Q-switched Nd:YAG laser and glycolic acid peel in melasma. Indian J Dermatol Venereol Leprol. 2012;78(2):165.PubMed

102.

Kim HS, Kim EK, Jung KE, Park YM, Kim HO, Lee JY. A split-face comparison of low-fluence Q-switched Nd:YAG laser plus 1550 nm fractional photothermolysis vs. Q-switched Nd:YAG monotherapy for facial melasma in Asian skin. J Cosmet Laser Ther. 2013;15(3):143–9.PubMed

103.

Shin JU, Park J, Oh SH, Lee JH. Oral tranexamic acid enhances the efficacy of low-fluence 1064-nm quality-switched neodymium-doped yttrium aluminum garnet laser treatment for melasma in Koreans: a randomized, prospective trial. Dermatol Surg. 2013;39(3 Pt 1):435–42.PubMed

104.

Jalaly NY, Valizadeh N, Barikbin B, Yousefi M. Low-power fractional CO₂ laser versus low-fluence Q-switch 1,064 nm Nd:YAG laser for treatment of melasma: a randomized, controlled, split-face study. Am J Clin Dermatol. 2014;15(4):357–63.PubMed

105.

Vachiramon V, Sirithanabadeekul P, Sahawatwong S. Low-fluence Q-switched Nd: YAG 1064-nm laser and intense pulsed light for the treatment of melasma. J Euro Acad Dermatol Venereol. 2015;29(7):1339–46.

106.

Vachiramon V, Sahawatwong S, Sirithanabadeekul P. Treatment of melasma in men with low-fluence Q-switched neodymium-doped yttrium–aluminum–garnet laser versus combined laser and glycolic acid peeling. Dermatol Surg. 2015;41(4):457–65.PubMed

107.

Passeron T, Fontas E, Kang HY, Bahadoran P, Lacour JP, Ortonne JP. Melasma treatment with pulsed-dye laser and triple combination cream: a prospective, randomized, single-blind, split-face study. Arch Dermatol. 2011;147(9):1106–8.PubMed

108.

Wind BS, Kroon MW, Meesters AA, Beek JF, van der Veen JW, Nieuweboer-Krobotová L, Bos JD, Wolkerstorfer A. Non-ablative 1,550 nm fractional laser therapy versus triple topical therapy for the treatment of melasma: a randomized controlled split-face study. Lasers Surg Med. 2010;42(7):607–12.PubMed

109.

Kroon MW, Wind BS, Beek JF, Van Der Veen JW, Nieuweboer-Krobotová L, Bos JD, Wolkerstorfer A. Nonablative 1550-nm fractional laser therapy versus triple topical therapy for the treatment of melasma: a randomized controlled pilot study. J Am Acad Dermatol. 2011;64(3):516–23.PubMed

110.

Nouri K, Bowes L, Chartier T, Romagosa R, Spencer J. Combination treatment of melasma with pulsed CO₂ laser followed by Q-switched alexandrite laser: a pilot study. Dermatol Surg. 1999;25(6):494–7.PubMed

111.

Angsuwarangsee S, Polnikorn N. Combined ultrapulse CO₂ laser and Q-switched alexandrite laser compared with Q-switched alexandrite laser alone for refractory melasma: split-face design. Dermatol Surg. 2003;29(1):59–64.PubMed

112.

Trelles MA, Velez M, Gold MH. The treatment of melasma with topical creams alone, CO₂ fractional ablative resurfacing alone, or a combination of the two: a comparative study. J Drugs Dermatol. 2010;9(4):315–22.PubMed

113.

Hong SP, Han SS, Choi SJ, Kim MS, Won CH, Lee MW, Choi JH, Moon KC, Kim YJ, Chang SE. Split-face comparative study of 1550 nm fractional photothermolysis and trichloroacetic acid 15% chemical peeling for facial melasma in Asian skin. J Cosmet Laser Ther. 2012;14(2):81–6.PubMed

114.

Hammami Ghorbel H, Boukari F, Fontas E, Montaudié H, Bahadoran P, Lacour JP, Passeron T. Copper bromide laser vs triple-combination cream for the treatment of melasma: a randomized clinical trial. JAMA Dermatol. 2015;151(7):791–2.PubMed

115.

Choi YJ, Nam JH, Kim JY, Min JH, Park KY, Ko EJ, Kim BJ, Kim WS. Efficacy and safety of a novel picosecond laser using combination of 1 064 and 595 nm on patients with melasma: a prospective, randomized, multicenter, split-face, 2% hydroquinone cream-controlled clinical trial. Lasers Surg Med. 2017;49(10):899–907.PubMed

116.

Chalermchai T, Rummaneethorn P. Effects of a fractional picosecond 1,064 nm laser for the treatment of dermal and mixed type melasma. J Cosmet Laser Ther. 2018;20(3):134–9.PubMed

117.

Lee HC, Thng TG, Goh CL. Oral tranexamic acid (TA) in the treatment of melasma: a retrospective analysis. J Am Acad Dermatol. 2016;75(2):385–92.PubMed

118.

Sadako N. Treatment of melasma with tranexamic acid. Clin Rep. 1979;13:3129–31.

119.

Hajime M, Mineo T, Yoshio T. Oral administration therapy with tranexamic acid for melasma. Nishinihon J Dermatol. 1985;47:1101–4.

120.

Higashi N. Treatment of melasma with oral tranexamic acid. Skin Res. 1988;30:676–80.

121.

Zhu HJ, Yang XH. The clinical study of acidum tranexamicum on melasma. Pharm Prog. 2001;3:178–81.

122.

Karn D, Kc S, Amatya A, Razouria EA, et al. Oral tranexamic acid for the treatment of melasma. Kathmandu Univ Med J. 2014;10:40–3.

123.

Wu S, Shi H, Wu H, Yan S, et al. Treatment of melasma with oral administration of tranexamic acid. Aesthet Plast Surg. 2012;36:964–70.

124.

Li Y, Sun Q, He Z, Fu L, et al. Treatment of melasma with oral administration of compound tranexamic acid: a preliminary clinical trial. J Eur Acad Dermatol Venereol. 2014;28:393–4.PubMed

125.

Lajevardi V, Ghayoumi A, Abedini R, Hosseini H, Goodarzi A, Akbari Z, Hedayat K. Comparison of the therapeutic efficacy and safety of combined oral tranexamic acid and topical hydroquinone 4% treatment vs. topical hydroquinone 4% alone in melasma: a parallel-group, assessor- and analyst-blinded, randomized controlled trial with a short-term follow-up. J Cosmet Dermatol. 2017;16(2):235–42.PubMed

126.

Padhi T, Pradhan S. Oral tranexamic acid with fluocinolone-based triple combination cream versus fluocinolone-based triple combination cream alone in melasma: an open labeled randomized comparative trial. Indian J Dermatol. 2015;60:520.PubMedPubMedCentral

127.

Tan AW, Sen P, Chua SH, Goh BK. Oral tranexamic acid lightens refractory melasma. Australas J Dermatol. 2017;58:e105–8.PubMed

128.

Sharma R, Mahajan VK, Mehta KS, Chauhan PS, Rawat R, Shiny TN. Therapeutic efficacy and safety of oral tranexamic acid and that of tranexamic acid local infiltration with microinjections in patients with melasma: a comparative study. Clin Exp Dermatol. 2017;42(7):728–34.PubMed

129.

Colferai MMT, Miquelin GM, Steiner D. Evaluation of oral tranexamic acid in the treatment of melasma. J Cosmet Dermatol. 2018. https://doi.org/10.1111/jocd.12830(Epub 9 Dec 2018).CrossRefPubMed

130.

Del Rosario E, Florez-Pollack S, Zapata L Jr, Hernandez K, Tovar-Garza A, Rodrigues M, Hynan LS, Pandya AG. Randomized, placebo-controlled, double-blind study of oral tranexamic acid in the treatment of moderate-to-severe melasma. J Am Acad Dermatol. 2018;78(2):363–9.PubMed

131.

Nagaraju D, Bhattacharjee R, Vinay K, Saikia UN, Parsad D, Kumaran MS. Efficacy of oral tranexamic acid in refractory melasma: a clinico-immuno-histopathological study. Dermatol Ther. 2018;31(5):e12704.PubMed

132.

Na JI, Choi SY, Yang SH, Choi HR, Kang HY, Park KC. Effect of tranexamic acid on melasma: a clinical trial with histological evaluation. J Eur Acad Dermatol Venereol. 2013;27(8):1035–9.PubMed

133.

Kim HJ, Moon SH, Cho SH, Lee JD, Kim HS. Efficacy and safety of tranexamic acid in melasma: a meta-analysis and systematic review. Acta Derm Venereol. 2017;97(7):776–81.PubMed

134.

Nestor M, Bucay V, Callender V, Cohen JL, Sadick N, Waldorf H. Polypodium leucotomos as an adjunct treatment of pigmentary disorders. J Clin Aesthet Dermatol. 2014;7(3):13–7.PubMedPubMedCentral

135.

Martin LK, Caperton C, Woolery-Lloyd H, et al. A randomized double-blind placebo-controlled study evaluating the effectiveness and tolerability of oral Polypodium leucotomos in patients with melasma. American Academy of Dermatology Annual Meeting: 16–20 March 2012; San Diego.

136.

Ahmed AM, López I, Perese F, et al. A randomized, double-blinded, placebo-controlled trial of oral Polypodium leucotomos extract as an adjunct to sunscreen in the treatment of melasma. JAMA Dermatol. 2013;149(8):981–3.PubMed

137.

Goh CL, Chuah SY, Tien S, Thng G, Vitale MA, Delgado-Rubin A. Double-blind, placebo-controlled trial to evaluate the effectiveness of Polypodium leucotomos extract in the treatment of melasma in asian skin: a pilot study. J Clin Aesthet Dermatol. 2018;11(3):14–9.PubMedPubMedCentral

138.

Handog EB, Galang DA, de Leon-Godinez MA, Chan GP. A randomized, double-blind, placebo-controlled trial of oral procyanidin with vitamins A, C, E for melasma among Filipino women. Int J Dermatol. 2009;48(8):896–901.PubMed

139.

Teo WL, Gan E, Jinghan A, Chuah SY, Alain K, et al. Double blind placebo controlled trial to evaluate of the effectiveness of a dietary supplement rich in carotenoids as adjunct to topical lightening cream for the treatment of melasma: a pilot study. Pigment Disord. 2015;2(2):164.

140.

Bissonnette R, Nigen S, Bolduc C, Méry S, Nocera T. Protection afforded by sunscreens containing inorganic sunscreening agents against blue light sensitivity induced by aminolevulinic acid. Dermatol Surg. 2008;34(11):1469–76.PubMed

141.

Hamadi SA, Mohammed MM, Aljaf AN, Abdulrazak A. The role of topical and oral melatonin in management of melasma patients. J Arab Univ Basic Appl Sci. 2009;8:30–42.

142.

Cohen BE, Elbuluk N. Microneedling in skin of color: a review of uses and efficacy. J Am Acad Dermatol. 2016;74(2):348–55.PubMed

Titel: Melasma Treatment: An Evidence-Based Review
verfasst von: Jacqueline McKesey
Andrea Tovar-Garza
Amit G. Pandya
Publikationsdatum: 04.12.2019
Verlag: Springer International Publishing
Erschienen in: American Journal of Clinical Dermatology / Ausgabe 2/2020
Print ISSN: 1175-0561
Elektronische ISSN: 1179-1888
DOI: https://doi.org/10.1007/s40257-019-00488-w

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