Eleonora Da Pozzo and Claudia Martini
Melasma is a common skin disease involving changes in normal skin pigmentation. It results from epidermal melanocyte hyperactivity that causes increased production and accumulation of melanin. The onset of the disease has been associated with sun exposure, drugs, genetic and hormonal factors. The primary focus of this review was to provide an updated overview of the main biological aspects behind skin pigmentation and melasma development.
As a second aim of this review, the main mechanisms by which different compounds could reduce melanogenesis were also discussed. Common hypo-pigmenting agents act by reducing the melanogenesis through several mechanisms; they can affect melanin transcription and glycosylation, inhibit tyrosinase (a pivotal enzyme in melanin synthesis), slow the melanosome transfer or increase the skin turnover. Although a number of skin-lightening agents were proposed for treatment of hyperpigmentary disorders, none of these has achieved satisfactory effects. In this light, the most recent therapeutic strategies for melasma, and emerging molecular targets to control skin pigmentation, such as MITF, Wnt and mTOR, were herein described.
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