UPDATE ON ORAL AND TOPICAL THERAPY FOR MELASMA IN REPRODUCTIVE AGE: A LITERATURE REVIEW

Authors

  • MEYLIA ARINDA CANDRA DEWI Faculty of Medicine, Universitas Muhammadiyah Surakarta, Jalan Ahmad Yani, Sukoharjo-57169, Central Java, Indonesia
  • MIRANDA AZAHRA Faculty of Medicine, Universitas Muhammadiyah Surakarta, Jalan Ahmad Yani, Sukoharjo-57169, Central Java, Indonesia
  • FLORA RAMONA SIGIT PRAKOESWA Faculty of Medicine, Universitas Muhammadiyah Surakarta, Jalan Ahmad Yani, Sukoharjo-57169, Central Java, Indonesia https://orcid.org/0000-0002-3625-6142
  • RATIH PRAMUNINGTYAS Faculty of Medicine, Universitas Muhammadiyah Surakarta, Jalan Ahmad Yani, Sukoharjo-57169, Central Java, Indonesia

DOI:

https://doi.org/10.22159/ijap.2025.v17s2.12

Keywords:

Melasma, Therapy, Hyperpigmentation

Abstract

Melasma is a common pigmentation disorder often seen in women of reproductive age with Fitzpatrick skin types IV-VI, characterized by symmetrical hyperpigmented patches on the face. Major factors influencing melasma include UltraViolet (UV) exposure, genetic predisposition, and hormonal changes. This condition can significantly impact patients' quality of life, thus requiring effective and safe therapeutic approaches. This study aims to evaluate the effectiveness and safety of various melasma treatments, both topical and systemic, based on the latest literature review. This research uses a literature review design with a PICO (Patient, Intervention, Comparison, Outcome) approach to select articles from PubMed and ScienceDirect databases. Articles analyzed include studies published in the last 5 years, written in English, and involving patients with melasma.

Various treatments for melasma, such as hydroquinone, Triple Combination Cream (TCC), tranexamic acid, vitamin D, and natural-based treatments, show effectiveness in reducing the severity of melasma. Mild side effects were reported for some treatments, such as irritation with hydroquinone or mild gastrointestinal disturbances with oral tranexamic acid. Each treatment has advantages in specific contexts, depending on the patient's needs and characteristics. All therapies evaluated show positive results with varying degrees of effectiveness. Treatment selection should consider the severity of melasma, patient tolerance to the medication, and potential side effects. An individualized approach and combination therapy can be adapted to optimally meet patient needs.

References

Abdalla MA, Nayaf MS, Hussein SZ. Evaluation of vitamin D in melasma patients. Revista Romana de Medicina de Laborator. 2019;27(2):219-21. doi: 10.2478/rrlm-2019-0023.

Ahmad Nasrollahi S, Sabet Nematzadeh M, Samadi A, Ayatollahi A, Yadangi S, Abels C. Evaluation of the safety and efficacy of a triple combination cream (hydroquinone, tretinoin, and fluocinolone) for treatment of melasma in middle Eastern skin. Clin Cosmet Investig Dermatol. 2019;12:437-44. doi: 10.2147/CCID.S202285, PMID 31354327.

Artzi O, Horovitz T, Bar‐Ilan E, Shehadeh W, Koren A, Zusmanovitch L. The pathogenesis of melasma and implications for treatment. J Cosmet Dermatol. 2021;20(11):3432-45. doi: 10.1111/jocd.14382, PMID 34411403.

Basit A, Rahman A, Uddin R. Oral tranexemic acid with triple combination cream (flucinolone+hydroquinone+tretinoin) versus triple combination cream alone in treatment of melasma. J Ayub Med Coll Abbottabad. 2021;33(2):293-8. PMID 34137548.

Bronzina E, Clement A, Marie B, Fook Chong KT, Faure P, Passeron T. Efficacy and tolerability on melasma of a topical cosmetic product acting on melanocytes, fibroblasts and endothelial cells: a randomized comparative trial against 4% hydroquinone. J Eur Acad Dermatol Venereol. 2020;34(4):897-903. doi: 10.1111/jdv.16150, PMID 31858658.

Cassiano DP, Esposito AC, Hassun KM, Lima MM, Lima EV, Miot LD. Histological changes in facial melasma after treatment with triple combination cream with or without oral tranexamic acid and/or microneedling: A randomised clinical trial. Indian J Dermatol Venereol Leprol. 2022;88(6):761-70. doi: 10.25259/IJDVL_126_2021, PMID 35389028.

Chatterjee M, Neema S, Rajput GR. A randomized controlled pilot study of a proprietary combination versus sunscreen in melasma maintenance. Indian J Dermatol Venereol Leprol. 2021;88(1):51-8. doi: 10.25259/IJDVL_976_18, PMID 34379946.

Chen Q, Liu L, Zhang Y. Vitamin D and wound healing: assessing skin barrier function and implications for chloasma treatment. Int Wound J. 2024;21(1):e14541. doi: 10.1111/iwj.14541, PMID 38272820.

De Amorim RP, Barbosa MM, Cassiano DP, Esposito AC, Dias MO, de Abreu AF. Sequential therapy with topical clobetasol for 14 d followed by hydroquinone versus hydroquinone alone in facial melasma treatment: a randomized, double-blind, controlled clinical trial. Int J Dermatol. 2024;63(9):1221-6. doi: 10.1111/ijd.17094, PMID 38411257.

Fabian IM, Sinnathamby ES, Flanagan CJ, Lindberg A, Tynes B, Kelkar RA. Topical hydroquinone for hyperpigmentation: a narrative review. Cureus. 2023;15(11):e48840. doi: 10.7759/cureus.48840, PMID 38106810.

Gan C, Rodrigues M. An update on new and existing treatments for the management of melasma. Am J Clin Dermatol. 2024;25(5):717-33. doi: 10.1007/s40257-024-00863-2, PMID 38896402.

Gonzalez Molina V, Marti Pineda A, Gonzalez N. Topical treatments for melasma and their mechanism of action. J Clin Aesthet Dermatol. 2022;15(5):19-28. PMID 35642229.

Horti A, Abbas SN, Fathima S, Razzaq MS, Mistry AP, Parveen FS. Efficacy of topical raphanus sativus seed powder mixed with honey versus hydroquinone 4% cream in the treatment of melisma-a randomized controlled trial. J Dermatol Sci Cosmet Technol. 2024;1(4):100057. doi: 10.1016/j.jdsct.2024.100057

Huang P, Acevedo SF, Cheng T, Mehta RC, Makino ET. A randomized, controlled, split-face, double-blind comparison of multimodality pigment-correcting serum containing lotus sprout extract versus hydroquinone for moderate to severe facial hyperpigmentation, including melasma, in a diverse population. JAAD Int. 2024;15:206-19. doi: 10.1016/j.jdin.2024.02.017, PMID 38707930.

Asilian A, Kazemipour S, Mokhtari F, Iraji F, Shahmoradi Z, Mohaghegh F. Effectiveness of dermabrasion plus 5-fluorouracil vs suction blister in treating vitiligo: a comparative study. Dermatol Ther. 2021;34(2):e14750. doi: 10.1111/dth.14750, PMID 33403790.

Konisky H, Balazic E, Jaller JA, Khanna U, Kobets K. Tranexamic acid in melasma: a focused review on drug administration routes. J Cosmet Dermatol. 2023;22(4):1197-206. doi: 10.1111/jocd.15589, PMID 36606378.

Lima PB, Dias JA, Cassiano DP, Esposito AC, Miot LD, Bagatin E. Efficacy and safety of topical isobutylamido thiazolyl resorcinol (Thiamidol) vs. 4% hydroquinone cream for facial melasma: an evaluator‐blinded, randomized controlled trial. J Eur Acad Dermatol Venereol. 2021;35(9):1881-7. doi: 10.1111/jdv.17344, PMID 33988887.

Mahajan VK, Patil A, Blicharz L, Kassir M, Konnikov N, Gold MH. Medical therapies for melasma. J Cosmet Dermatol. 2022;21(9):3707-28. doi: 10.1111/jocd.15242, PMID 35854432.

Muchtaridi M, Dewi ML. The recent update of deoxyarbutin: a skin depigmentation agent with tyrosinase inhibition targeting. Int J App Pharm. 2020;12(3):1-7. doi: 10.22159/ijap.2020v12i3.36957.

Patel D, Khanna N, Sharma V. Comparative evaluation of triple combination cream versus hydroquinone monotherapy in the treatment of melasma: a randomized controlled trial. J Clin Aesthetic Dermatol. 2019;12(4):34-9.

Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (Perdoski) Pedoman Praktik Klinis: diagnosis dan tata laksana melasma. Jakarta: Perdoski; 2021. p. 363.

Philipp Dormston WG. Melasma: a step-by-step approach towards a multimodal combination therapy. Clin Cosmet Investig Dermatol. 2024;17:1203-16. doi: 10.2147/CCID.S372456, PMID 38800358.

Piętowska Z, Nowicka D, Szepietowski JC. Understanding melasma-how can pharmacology and cosmetology procedures and prevention help to achieve optimal treatment results? A narrative review. Int J Environ Res Public Health. 2022;19(19):12084. doi: 10.3390/ijerph191912084, PMID 36231404.

Platsidaki E, Markantoni V, Nicolaidou E, Katoulis A, Rigopoulos D, Stratigos AJ. Melasma: a clinical and epidemiological single-group observational study in the Greek population. Dermatol Ther (Heidelb). 2024;14(11):3183-92. doi: 10.1007/s13555-024-01297-8, PMID 39485595.

Ammar AA, Salem HA, Eladawy SA, Elsamad ZI, Kohaf NA. Development and clinical evaluation of topical hydroquinone niosomal gel formulation for the treatment of melasma. Int J App Pharm. 2020;12(4):228-36. doi: 10.22159/ijap.2020v12i4.34304.

Shope C, Andrews L, DeVore A, Wine Lee L, Wagner C. Melasma is associated with lower serum vitamin D concentrations as compared to healthy controls. J of Skin. 2023;7(3):794-6. doi: 10.25251/skin.7.3.5.

Sinta M, Sulistyani S, Ratnasari Y, Milyarona FP. Peran kadar vitamin d darah terhadap derajat keparahan klinis pasien bell’s palsy. JIMI. 2023;3(1):1-8. doi: 10.35912/jimi.v3i1.1470.

Singh A, Verma P, Kumar S. Evaluation of raphanus sativus extract cream in the management of facial melasma: a pilot randomized placebo-controlled trial. Int J Dermatol. 2022;61(5):587-93.

Yasnova N, Sirait SP, Rahmayunita G. The effectiveness and safety of 3% tranexamic acid cream vs. 4% hydroquinone cream for mixed-type melasma in skin of color: a double-blind, split-face, randomized controlled trial. Acta Dermatovenerol Alp Pannonica Adriat. 2024;33(2):83-8. doi: 10.15570/actaapa.2024.16, PMID 38918942.

Adisti Nina Yuniandari AA, Wijayanti D. Evaluating the efficacy and safety of tranexamic acid to hydroquinone and triple combination cream in the treatment of melasma. JHS. 2022;3(11):1643-57. doi: 10.46799/jhs.v3i11.663.

Zahid M, Lodhi M, Afzal A, Rehan ZA, Mehmood M, Javed T. Development of hydrogels with the incorporation of Raphanus sativus L. seed extract in sodium alginate for wound-healing application. Gels. 2021;7(3):107. doi: 10.3390/gels7030107, PMID 34449597.

Published

15-06-2025

How to Cite

DEWI, M. A. C., AZAHRA, M., PRAKOESWA, F. R. S., & PRAMUNINGTYAS, R. (2025). UPDATE ON ORAL AND TOPICAL THERAPY FOR MELASMA IN REPRODUCTIVE AGE: A LITERATURE REVIEW. International Journal of Applied Pharmaceutics, 17(2), 21–27. https://doi.org/10.22159/ijap.2025.v17s2.12

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Review Article(s)

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