- Pathogenesis of melasma (chloasma) (pregnancy mask) remains unknown. Treatment which is effective on the epidermal component of the pigmentation acts by the following mechanisms:
- inhibition of melanin synthesis
- blockage of melanosome transker from melanocytes and keratinocytes (niacinamide).
- Solar eviction and photoprotection are a crucial element in the treatments.
- The gold standard in the treatment of melasma is hydroquinone which is an inhibitor of tyrosinase. However it is toxic to pigment cells (melanocytes) (phenolic molecule).
- Another phenolic and toxic molecule is N-acetyl-4-S-cysteaminylphenol. Recently a metabolite of the latter called cysteamine mercaptoethylamine has re-emerged. It is a thiolic, non-melanotoxic compound, which has recently become useable thanks to a new toxicology stabilizing it and reducing the strong smell, which was user unfriendly.
- Other non-toxic compounds include:
- kojic acid which is produced by a fungus called Arpergilline oryzae.
- azelaic acid
- tretinoin
- liquirtan
- combination treatments (hydroquinone, steroids, tretinoin)
GOH CL. Medical treatment of Melasma. 9th Asian Dermatological Congress (ADC) 13 – Hong Kong, SAR
Original article: here
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