Section : Conference Notes

Treatment of melasma (chloasma) (pregnancy mask) with Creams (For Professionals)

  • Pathogenesis of melasma (chloasma) (pregnancy mask) remains unknown. Treatment which is effective on the epidermal component of the pigmentation acts by the following mechnisms:
    • inhibition of melanin synthesis
    • blockage of melanosome transker from melanocytes and keratinocytes (niacinamide).
  • Solar eviction and photoprotection are a crucial element in the treatments.
  • The gold standard in the treatment of melasma is hydroquinone which is an inhibitor of tyrosinase. However it is toxic to pigment cells (melanocytes) (phenolic molecule).
  • Another phenolic and toxic molecule is N-acetyl-4-S-cysteaminylphenol. Recently a metabolite of the latter called cysteamine mercaptoethylamine has re-emerged. It is a thiolic, non-melanotoxic compound, which has recently become useable thanks to a new toxicology stabilizing it and reducing the strong smell, which was user unfriendly.
  • Other non-toxic compounds include:
    • kojic acid which is produced by a fungus called Arpergilline oryzae.
    • azelaic acid
    • tretinoin
    • liquirtan
    • combination treatments (hydroquinone, steroids, tretinoin)

Contributors:

Dr Christophe HSU – dermatologist. Geneva, Switzerland

GOH CL. Medical treatment of Melasma. 9th Asian Dermatological Congress (ADC) 13 – Hong Kong, SAR