A Scoping Review on Melasma Treatments and Their Histopathologic Correlates

Area of Science:

• Dermatology
• Pathology

Background:

• Melasma is a common dyschromia affecting women, particularly those with skin of color.
• It presents in epidermal, mixed, and dermal variants based on lesion depth.
• Limited research exists on melasma treatments and their dermatopathological correlations.

Purpose of the Study:

• To conduct a scoping review of human trials on melasma with histopathologic analysis.
• To identify treatments with strong histopathologic evidence for different melasma variants.
• To assess the availability of research on quality of life in melasma treatment.

Main Methods:

• A comprehensive scoping review of human trials involving melasma and histopathologic analysis was performed.
• Thirty-seven trials were included in the final analysis.
• Studies primarily focused on women with Fitzpatrick skin types III or greater.

Main Results:

• Strong histologic evidence supports retinoids/retinol for epidermal melasma treatment.
• Microneedling demonstrates significant histopathologic support for treating dermal melasma.
• A notable lack of trials with histologic correlates and quality of life analyses was observed.

Conclusions:

• Retinoids and microneedling are supported by histologic evidence for specific melasma types.
• There is a critical need for more research correlating melasma treatments with histopathology and quality of life outcomes.