Melasma: A Condition of Asian Skin

Wu, Michelle; R, Antony; Mayrovitz, Harvey N.

doi:10.7759/cureus.14398

Cited by 10 publications

(9 citation statements)

References 46 publications

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“…Melasma is known to be easy to diagnose, difficult to treat, and easy to relapse. 25 The pathogenesis of melasma is unclear, although it is linked to sun damage, endocrine level, genetics, vasculature, and other factors. 26 Studies have confirmed that there is basement membrane damage in melasma lesions.…”

Section: Discussionmentioning

confidence: 99%

Stem cell‐derived exosomes in the treatment of melasma and its percutaneous penetration

et al. 2022

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Background and Objectives: Melasma is a refractory skin disease due to its complex pathogenesis and difficult treatment. Studies have found that human umbilical cord mesenchymal stem cell-derived exosomes (hUCMSC-Exos) could serve as a novel cell-free therapeutic strategy in regenerative and esthetic medicine. It could potentially treat melasma, but the skin barrier is a challenge. In this study, we aim to explore the safety and efficacy of hUCMSC-Exos in the treatment of melasma and the means to promote its percutaneous penetration. Materials and Methods: In the animal study about the effect of penetration, percutaneous penetration of PKH67-labeled hUCMSC-Exos was studied under microneedles, 1565 nm nonablative fractional laser (NAFL), and a plasma named Peninsula Blue Aurora Shumin Master (PBASM) treatments, observed by confocal laser scanning microscopy. In the clinical application study, 60 patients with melasma treated in our department were divided into four groups. NAFL combined with normal saline treatment was used for Group A. Microneedles, NAFL, and PBASM combined with hUCMSC-Exos treatments were used for Groups B, C, and D, respectively. Each patient received four treatments at 1-month intervals. Assessments were done using the degree of pain posttreatment, melasma area and severity score, improvement rate, physician global assessment score, satisfaction, and complications. Results: In the animal study about the effect of penetration, hUCMSC-Exos can penetrate the deep dermis under microneedles, NAFL, and PBASM treatments. In the clinical application study, compared with Group A, Groups B, C, and D showed significantly improved therapeutic effect and patient satisfaction (p < 0.05), and there was no significant difference among Groups B, C, and D.(p > 0.05). Patients in Group B reported higher pain levels than those in the other three groups (p < 0.05); the treatment experience of patients in Group D was better. Conclusion: hUCMSC-Exos can improve the symptoms of melasma safely and effectively. Compared with microneedles, NAFL and PBASM can also achieve a good effect toward promoting penetration. These findings are worthy of exploration and clinical application.

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Section: Discussionmentioning

confidence: 99%

Stem cell‐derived exosomes in the treatment of melasma and its percutaneous penetration

et al. 2022

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“…Melasma is common in Asian skin. 78 The primary risk factors for developing melasma are female hormone variations and exposome factors such as chronic sun exposure and pollution, as well as genetics. 79,80 Protection against VL/HEV is essential, in addition to broadspectrum and well-balanced UVB/UVA protection, all year-round for the treatment of melasma and prevention of relapses.…”

Section: Melasmamentioning

confidence: 99%

Awareness of sun exposure risks and photoprotection for preventing pigmentary disorders in Asian populations: Survey results from three Asian countries and expert panel recommendations

Goh,

Kang,

Morita

et al. 2023

Photoderm Photoimm Photomed

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BackgroundIn this article, we review and discuss the photoprotection behavior of Asians based on the literature, along with a subanalysis of an original online survey, and make recommendations to optimize photoprotection for Asian populations to prevent photoaging and pigmentary disorders.MethodsAn international panel of eight dermatologists from Asia (China, Korea, Japan, Singapore, Indonesia, and Vietnam) met to discuss sunscreen photoprotection for Asian patients. Additionally, a subanalysis of an online survey by 3000 respondents from three Asian countries (China, Indonesia, and Japan) investigated general public awareness and attitudes to sun exposure.ResultsA pre‐meeting survey of the eight experts from Asia showed key concerns of Asian patients consulting dermatologists are pigmentary disorders, especially actinic/senile lentigo, post‐inflammatory hyperpigmentation, melasma, vitiligo, and Hori's nevus. The survey subanalysis of participants from China, Indonesia, and Japan with predominantly Fitzpatrick skin types (FST) II to IV revealed that they are particularly concerned about sun exposure causing photoaging and pigmentary disorders. Most of the respondents indicated they have limited knowledge on sunlight radiation and appropriate sunscreen protection factors. Only 22%, 13%, and 3% for China, Indonesia, and Japan, respectively, systematically use multiple protective measures (using sunscreen, avoiding midday sun, staying in the shade, wearing a hat, protective clothing, and sunglasses) when exposed to the sun.ConclusionsFurther education is needed for Asian populations on the importance of comprehensive daily photoprotection, including broad‐spectrum sunscreen, with high UVA and visible light protection, to reduce and prevent photoaging and pigmentary disorders.

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“…2,3 Melasma occurs in most races and ethnicities, but it is more prevalent among women of darker skin types (Fitzpatrick skin phototypes IV-VI), particularly Asians, Hispanics, and individuals of African descent. 4,5 Because of its location and severe discoloration, melasma can cause tremendous emotional and psychosocial distress in patients and plays a major role in adversely affecting patients' quality of life (QoL). 5,6…”

Section: Introductionmentioning

confidence: 99%

Optimizing Melasma Management With Topical Tranexamic Acid: An Expert Consensus

Desai¹,

Lee²,

Handog³

et al. 2023

JDD

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Because of its complex pathogenesis, chronicity, and high rates of recurrence, melasma is regarded as a challenging skin disorder. Topical treatments are often offered as first-line therapy. However, many patients are unaware that melasma is recurrent and requires long-term management. Hydroquinone is effective for controlling relapses and has become the standard of care for melasma in many countries. Nonetheless, it is limited by its side effect profile. Certain patient profiles who have had prior therapy and/or are refractory to treatment may be offered an alternative, that is topical tranexamic acid (TXA) alone or in combination with other modalities. This review provides a summary of current evidence on topical TXA as a treatment for certain case profiles. This paper aims to fill knowledge gaps in terms of currently available options, highlighting the role of topical TXA alone or in combination with other active ingredients (ie, topical TXA 2% with patented delivery technology).

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Melasma: A Condition of Asian Skin

Cited by 10 publications

References 46 publications

Stem cell‐derived exosomes in the treatment of melasma and its percutaneous penetration

Stem cell‐derived exosomes in the treatment of melasma and its percutaneous penetration

Awareness of sun exposure risks and photoprotection for preventing pigmentary disorders in Asian populations: Survey results from three Asian countries and expert panel recommendations

Optimizing Melasma Management With Topical Tranexamic Acid: An Expert Consensus

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