Targeting Melasma: Innovations in Pigment Deposition and Photoaging in Cosmetic Dermatology

Several human studies show positive signals, while research methods and sample sizes continue to develop.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Melasma is a chronic, relapsing hyperpigmentation disorder driven by complex interactions among genetic predisposition, hormonal fluctuations, UV exposure, oxidative stress, inflammation, and photoaging. Its psychosocial impact is substantial, especially among women with darker skin types, and treatment remains challenging due to its multifactorial pathogenesis and high recurrence rates. Aims This review aims to synthesize current knowledge on melasma pathophysiology, highlight recent innovations in topical and procedural therapies, identify limitations of existing treatments, and outline future directions toward personalized and regenerative approaches. Patients/methods A narrative literature review was performed, summarizing findings from epidemiologic studies, molecular investigations, and clinical trials. Key topics included pigment biology, hormonal and environmental triggers, oxidative stress pathways, emerging depigmenting agents, laser and microneedling technologies, combination therapies, and advances in precision medicine. Results Melasma arises from dysregulated melanogenesis involving hyperactive melanocytes, hormonal stimulation, UV-induced oxidative stress, dermal inflammation, fibroblast senescence, and pigmentary incontinence. Innovations include non-hydroquinone brighteners (e.g., thiamidol, melasyl), antioxidants, tranexamic acid, and improved topic

Evidence level

Several human studies show positive signals, while research methods and sample sizes continue to develop.

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