The efficacy of cysteamine as a melasma therapy: a systematic review of trial studies

Melasma is a chronic and refractory hyperpigmentation disorder that predominantly affects women and individuals with darker skin tones. Treatment remains challenging due to issues related to efficacy, side effects, and high recurrence rates. Cysteamine is a depigmenting agent that has demonstrated promising outcomes in melasma management with minimal adverse effects. This study evaluates the effectiveness of cysteamine as a treatment for melasma. A systematic review was conducted using databases from PubMed, Google Scholar, and ScienceDirect, including articles published over the past 10 years (2013-2023). Eight studies met the inclusion criteria for this review. Cysteamine showed good therapeutic efficacy, reflected in reductions in the melasma area and severity index (MASI) ranging from 1.5 to 10.07, with a mean decrease of 5.73. No severe adverse effects were reported, and only mild reactions such as erythema, itching, irritation, dry skin, tingling, and burning sensations were noted. Overall, cysteamine is demonstrated to be an effective and safe therapy for melasma, offering satisfactory clinical improvement with minimal side effects.