Melasma update

Arora, Pooja; Garg, VijayKumar; Sonthalia, Sidharth; Gokhale, Narendra; Sarkar, Rashmi

doi:10.4103/2229-5178.142484

Cited by 85 publications

(41 citation statements)

References 46 publications

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“…Patients with melisma were treated with topical silymarin cream 0.1% and 0.2%, two times per day for 4 weeks, and no adverse effects were reported (Sarkar, Arora, Garg, Sonthalia, & Gokhale, 2014). In a randomized, double-blinded placebo controlled trial on patients with gastrointestinal cancer who had hand-foot syndrome due to capecitabine, application of silymarin gel 1% twice daily for 9 weeks had no adverse effects (Elyasi et al, 2017).…”

Section: Safety and Adverse Effects Of Topical Silymarin In Humanmentioning

confidence: 99%

Safety and toxicity of silymarin, the major constituent of milk thistle extract: An updated review

Soleimani

Delghandi

Moallem

et al. 2019

Phytotherapy Research

154

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Milk thistle (Silybum marianum) is a medicinal plant from the Asteraceae family. Silymarin is the major constituent of milk thistle extract and is a mixture of some flavonolignans such as silybin, which is the most active component of silymarin. It is most commonly known for its hepatoprotective effect. Also, studies have shown other therapeutic effects such as anticancer, anti‐Alzheimer, anti‐Parkinson, and anti‐diabetic, so its safety is very important. It has no major toxicity in animals. Silymarin was mutagen in Salmonella typhimurium strains in the presence of metabolic enzymes. Silybin, silydianin, and silychristin were not cytotoxic and genotoxic at concentration of 100 μM. Silymarin is safe in humans at therapeutic doses and is well tolerated even at a high dose of 700 mg three times a day for 24 weeks. Some gastrointestinal discomforts occurred like nausea and diarrhea. One clinical trial showed silymarin is safe in pregnancy, and there were no anomalies. Consequently, caution should be exercised during pregnancy, and more studies are needed especially in humans. Silymarin has low‐drug interactions, and it does not have major effects on cytochromes P‐450. Some studies demonstrated that the use of silymarin must be with caution when co‐administered with narrow therapeutic window drugs.

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Section: Safety and Adverse Effects Of Topical Silymarin In Humanmentioning

confidence: 99%

Safety and toxicity of silymarin, the major constituent of milk thistle extract: An updated review

Soleimani

Delghandi

Moallem

et al. 2019

Phytotherapy Research

154

View full text Add to dashboard Cite

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“…Its treatment often results in unsatisfactory outcomes and hence it remains a challenge (1). Melasma affects about 1.5% to 33.3% of people (2). The main pathogenesis of melasma is not completely known (3) although vascularization is considered a source of development (4).…”

Section: Evidence Acquisitionmentioning

confidence: 99%

“…Vascularization is caused by angiogenesis (creation of new vessels) as a consequence of regulators such as vascular endothelial growth factor (VGEF). High vascular endothelial growth factor could be a possible reason for the increase of vascularization in melasma lesions (2).…”

Section: Evidence Acquisitionmentioning

confidence: 99%

The Relationship Between Herbal Anticoagulants and Melasma

et al. 2016

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Context: Melasma is a common pigmentary disorder with the incidence of 1.5%-33.3% worldwide. Targeting the vascular component in melasma lesions may decrease the melanocytic stimulation. Herbal anticoagulants can serve as effective candidates for melasma treatment. Evidence Acquisition: The evidence was gathered in this study by evaluating vascularization as an etiology of melasma and considering the role of herbal anticoagulants in natural vascular treatment. Databases such as PubMed and Scopus were screened and the following keywords were searched: melasma, vascularization, pigmentation, and herbal anticoagulant. These subjects were further investigated in traditional textbooks such as the canon of medicine by Avicenna and Alhavi by Razi. At the end, the results were discussed. Result: The use of anticoagulants can reduce the clot formation and lower the VEGF release. In this way, vascularization will be reduced, consequently leading to a decrease in melasma occurrence. The researchers of the present study went over the herbal components that were effective for treatment of melasma and found that most of them consisted of anticoagulants such as coumarin. Conclusion: The effect of herbal anticoagulants (administered orally) on melasma should be evaluated clinically and their combination with topical treatments is suggested.

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“…Depigmenting drugs, retinoids, and sunscreen are the mainstay of therapy for extrafacial melasma. [ 5 6 ] It is premature to comment whether extrafacial melasma responds to depigmenting therapy akin to typical facial melasma.…”

mentioning

confidence: 99%