Melazma Tedavisinde Güncel Yaklaşımlar ve Olası Toksik Etkileri

Melasma is a chronic and localized pigmentation disorder that arises from increased melanin accumulation due to the enhanced number and activity of melanocytes in epidermis and/or dermis. This disorder appears on the parts of face, which are highly exposed to light and seen as hypermelanosis. Even if treated successfully, it can relapse. Most cases of melasma are seen in dark skin-toned (Fitzpatrick skin type IV – VI) and reproductive-aged women who are living in regions with high ultraviolet radiation. However, it is also encountered in different people with every age, race and skin color. Pathogenesis of melasma is complicated and variable and it is thought to occur because of complex interactions between epidermal melanocytes, keratinocytes, dermal fibroblasts, mast cells and vascular endothelial cells. Although some factors like sun exposure, genetic predisposition, pregnancy, oral contraceptive and steroid use, ovary tumors, use of irritant cosmetic products and use of drugs that cause photosensitivity were described for its etiopathogenesis, the accurate cause of malesma is not known. In this review, recent developments in the pathogenesis and treatment of melasma will be summarized, and the efficacy and toxic effects of current and new treatment options will be discussed.