Botanicals in Melasma
Evangeline B. Handog, Maria Juliet Enriquez-Macarayo, and Ricky Hipolito
Greater understanding of the pathogenesis of melasma has given way to more pharmacologic agents especially those of botanical origin. While the role of tyrosinase is well known, many new pathways have been elucidated with molecular research; transcription and posttranslational modification of tyrosinase and other melano- genic enzymes have now been found to be targets of treatment .
With free radicals and peroxides inducing melanin formation, molecules with free radical scavenging and antioxidant properties were found to have therapeutic value in melasma. As the understanding of melasma pathophysiology deepens, coupled with clinical research, molecules of botanical origin with less adverse effects than existing therapies are emerging and finding their way into the mainstream treatment regimens.
Even with many currently existing treatments, melasma remains a management challenge. The condition has a tendency to relapse which contributes to patient dissatisfaction. Moreover, the gold standard, hydroquinone has been documented to cause ochronosis with prolonged use. Other available treatments include topical retinoids, azelaic acid, and kojic acid. Peeling agents with benefit in melasma include
E.B. Handog (*)
Department of Dermatology, Asian Hospital and Medical Center,
Department of Dermatology, Angeles University Foundation Medical Center,
Department of Dermatology, Research Institute for Tropical Medicine, Filinvest Corporate City, Alabang, Muntinlupa City, Philippines
© Springer India 2017
E.B. Handog, M.J. Enriquez-Macarayo (eds.), Melasma and Vitiligo in Brown Skin, DOI 10.1007/978-81-322-3664-1_13
glycolic, trichloroacetic, salicylic, and lactic acid. All of the above agents either have harmful side effects on prolonged use or does not prevent relapse of melasma .
Fisk et al in their review article published in 2014 showed that botanical agents are becoming popular alternative therapies for hyperpigmentation . These agents are more effective in superficial forms of hyperpigmentation and as such should be considered for integration into standard regimens. However, the review also showed that further clinical studies integrating botanicals with accepted treatments are needed.
The following botanicals that will be discussed are well studied, supported by in vitro and clinical research. These are already incorporated into cosmeceuticals available in the market.