Melasma Literature Review

The literature review will begin by constructing a framework defining Melasma and its interventions. According to Hurley, M.E., Guevara, I.L., Gonzales, R.M. and Pandya, A.G., (2002) Melasma is a pigmentation disorder and is common among women of Hispanic and Asian groups arising from biologically active melanocytes, associated with high vascularity in the areas and occurrence of angio-genic factor in the epidermis. At the outset, it is important to understand Melasma as a disorder and explore the reasons for its occurrence. The etiology of melasma has yet to be established, and the course of treatment continues to be a challenge.
Traditionally, treatment strategy comprise of broad-spectrum sunscreens and topical hypo pigmenting agents

Their clinical study focused on 25 women taking two TXA tablets three times a day and using a topical TXA agent twice a day, over a period of 2 months. The factors measured were pigmentation and erythema using a Mexameter to establish skin biopsies for eight volunteers before and for a period of 8 weeks post the treatment. The results were obtained by staining using Fontana-Masson, anti-CD31, antitryptase, antitype IV collagen. The results of this study showed that there were no serious adverse events for the study period. The index for the mean Lesional Melanin Index (MI) scores showed decreased significantly. The MI scores for perilesional skin increased, while the erythema Index scores of lesional and perilesional skin also showed a similar pattern. Histological analysis in terms of significant reduction of epidermal pigmentation, vessel numbers and mast cell counts. Type IV collagen staining was not observed in all specimens. The findings of this study, established that the use of TXA had a positive effect. It lowered epidermal pigmentation associated with melasma and more significantly ‘reversed melasma-based changes;’ and vessel number and also increased number of mast