Outcomes of Treatment With Oral Melatonin in Patients With Recalcitrant Melasma
abstract
This abstract is available on the publisher's site.
Access this abstract nowMelasma is a common acquired hyperpigmentary disorder with a relapsing and remitting course. It presents as blotchy hyperpigmentation, usually over the face. However, cases of extrafacial melasma have also been reported. The pathophysiology of melasma involves the interaction of various factors and processes in the epidermis and dermis. It is triggered by sun exposure, drugs, and hormonal changes. Understanding the pathogenesis is mandatory for the treatment of melasma. The available treatment options for melasma include topicals, systemic drugs, and procedural therapies. Melatonin is a newer molecule that has been explored in melasma, albeit few research articles are available. Hence, we report a series of seven cases of recalcitrant melasma and examine the efficacy of oral melatonin for melasma.
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Use of oral melatonin in recalcitrant melasma
Int. J. Dermatol 2024 Apr 22;[EPub Ahead of Print], R Sarkar, B Verma, V MendirattaFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
This article by Sarkar et al reports the efficacy of oral melatonin for the treatment of patients with recalcitrant melasma. In this trial, 7 patients were treated with 3 mg of melatonin plus a broad-spectrum sunscreen for 12 weeks. There was a decrease in the modified Melasma Area and Severity Index scores of all patients at 12 weeks. Melatonin, secreted by the pineal gland, is commonly associated with the regulation of circadian rhythms. However, multiple studies document a spectrum of regulatory functions associated with melatonin, including oxidative stress, melanin pigmentation, and immune regulation.1
Several studies have indeed reported the efficacy of topical and oral melatonin in patients with melasma.2 In addition, a recent study documented the enhanced efficacy of the combination of melatonin and tranexamic acid compared with tranexamic acid monotherapy.3 Given the limited number of patients included in the investigation by Sarkar et al and other published trials, we are in dire need of new and well-designed randomized studies that assess the efficacy and short- and long-term safety of melatonin as a treatment for melasma.
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