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Acne is a multifactorial skin condition primarily affecting adolescents and young adults, with a global prevalence estimated to exceed 75% in this demographic. The condition is characterized by the formation of comedones (blackheads and whiteheads), papules, pustules, nodules, and, in severe cases, cysts, particularly in areas rich in sebaceous glands such as the face, neck, chest, and back. The pathogenesis involves increased sebum production, follicular hyperkeratinization, colonization by...
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Related Experiment Video

Updated: May 23, 2026

Roller Microneedle Combined with Tranexamic Acid Solution in Treating Melasma
04:12

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Published on: January 19, 2024

Innovations in Refractory Melasma: Mechanism-Based Management and Emerging Therapeutic Strategies.

Sofía Laguna Rocafort1,2, Jeevan Rivera-Díaz1,2, Ingrid M Bonilla2

  • 1School of Medicine, Universidad Central del Caribe, Bayamón, PRI.

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|May 22, 2026
PubMed
Summary

Melasma is a common skin hyperpigmentation disorder affecting women. Effective management requires a multimodal approach, including photoprotection and emerging therapies for challenging cases.

Keywords:
cholasmahormonal pigmentationhyperpigmentationmelaninmelasma

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Area of Science:

  • Dermatology
  • Pathophysiology
  • Medical Science

Background:

  • Melasma is a prevalent, chronic skin condition causing hyperpigmentation, primarily in women.
  • Its multifactorial pathophysiology involves UV radiation, hormones, inflammation, and cellular signaling.
  • Accurate diagnosis relies on clinical assessment, Wood's lamp, and dermoscopy.

Purpose of the Study:

  • To provide an updated narrative review of melasma's epidemiology, pathophysiology, diagnosis, and management.
  • To emphasize emerging therapeutic strategies for refractory melasma.
  • To offer clinically relevant insights for melasma treatment.

Main Methods:

  • A narrative review adhering to the Scale for the Assessment of Narrative Review Articles (SANRA).
  • Comprehensive literature search across multiple databases for peer-reviewed studies on melasma.
  • Qualitative synthesis of findings on pathogenesis, diagnosis, and treatment.

Main Results:

  • Melasma pathogenesis involves complex interactions of UV radiation, hormones, dermal remodeling, inflammation, and cellular signaling.
  • Diagnosis is primarily clinical, aided by Wood's lamp and dermoscopy.
  • Management necessitates a multimodal strategy, prioritizing photoprotection, with options including topical agents, systemic therapies, peels, microneedling, and laser treatments.

Conclusions:

  • Melasma is a challenging, recurrent pigmentary disorder requiring individualized, combination treatment strategies.
  • Strict photoprotection is fundamental for sustained clinical improvement.
  • Further research is crucial for optimizing long-term outcomes and quality of life for melasma patients.