{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T13:10:46Z","timestamp":1792242646106,"version":"4.4.0"},"reference-count":247,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,24]],"date-time":"2022-09-24T00:00:00Z","timestamp":1663977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Melasma is a chronic skin condition that involves the overproduction of melanin in areas exposed to ultraviolet radiation. Melasma treatment is long-term and complicated with recurrence and resistance to treatment. The pathogenesis of melasma is highly complex with multiple pathologies occurring outside of the skin pigment cells. It includes photoaging, excessive melanogenesis, an increased number of mast cells, increased vascularization, and basement membrane damage. In addition, skin lesions related to melasma and their surrounding skin have nearly 300 genes differentially expressed from healthy skin. Traditionally, melasma was treated with topical agents, including hydroquinone, tretinoin, glucocorticosteroids and various formulations; however, the current approach includes the topical application of a variety of substances, chemical peels, laser and light treatments, mesotherapy, microneedling and\/or the use of systemic therapy. The treatment plan for patients with melasma begins with the elimination of risk factors, strict protection against ultraviolet radiation, and the topical use of lightening agents. Hyperpigmentation treatment alone can be ineffective unless combined with regenerative methods and photoprotection. In this review, we show that in-depth knowledge associated with proper communication and the establishment of a relationship with the patient help to achieve good adherence and compliance in this long-term, time-consuming and difficult procedure.<\/jats:p>","DOI":"10.3390\/ijerph191912084","type":"journal-article","created":{"date-parts":[[2022,9,25]],"date-time":"2022-09-25T23:13:27Z","timestamp":1664147607000},"page":"12084","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Understanding Melasma-How Can Pharmacology and Cosmetology Procedures and Prevention Help to Achieve Optimal Treatment Results? A Narrative Review"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1593-1495","authenticated-orcid":false,"given":"Zuzanna","family":"Pi\u0119towska","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology, Wroc\u0142aw Medical University, 50-368 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1717-4280","authenticated-orcid":false,"given":"Danuta","family":"Nowicka","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology, Wroc\u0142aw Medical University, 50-368 Wroc\u0142aw, Poland"},{"name":"Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0766-6342","authenticated-orcid":false,"given":"Jacek C.","family":"Szepietowski","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology, Wroc\u0142aw Medical University, 50-368 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1001\/archderm.1961.01580080114013","article-title":"A Melanosis of the Face (\u201cChloasma\u201d)","volume":"83","author":"Newcomer","year":"1961","journal-title":"Arch. Dermatol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Rajanala, S., Maymone, M.B.D.C., and Vashi, N.A. (2019). Melasma pathogenesis: A review of the latest research, pathological findings, and investigational therapies. Dermatol. Online J., 25.","DOI":"10.5070\/D32510045810"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Kwon, S.-H., Hwang, Y.-J., Lee, S.-K., and Park, K.-C. (2016). Heterogeneous Pathology of Melasma and Its Clinical Implications. Int. J. Mol. Sci., 17.","DOI":"10.3390\/ijms17060824"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1111\/exd.13844","article-title":"Melasma: Updates and perspectives","volume":"28","author":"Kwon","year":"2019","journal-title":"Exp. Dermatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1038\/jid.1962.136","article-title":"Melanogenesis in human skin following exposure to long-wave ultraviolet and visible light","volume":"39","author":"Pathak","year":"1962","journal-title":"J. Investig. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1001\/archderm.1995.01690240119022","article-title":"Melasma. Etiologic and therapeutic considerations","volume":"131","author":"Grimes","year":"1995","journal-title":"Arch. Dermatol."},{"key":"ref_7","first-page":"53","article-title":"Melasma in Men: A Review of Clinical, Etiological, and Management Issues","volume":"11","author":"Sarkar","year":"2018","journal-title":"J. Clin. Aesthetic Dermatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1111\/j.1365-4632.2012.05748.x","article-title":"Epidemiology of melasma in Brazilian patients: A multicenter study","volume":"53","author":"Hexsel","year":"2014","journal-title":"Int. J. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s13555-017-0194-1","article-title":"Melasma: An Up-to-Date Comprehensive Review","volume":"7","author":"Elbuluk","year":"2017","journal-title":"Dermatol. Ther."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Handog, E.B., and Enriquez-Macarayo, M.J. (2017). Melasma and Comorbidities. Melasma and Vitiligo in Brown Skin, Springer.","DOI":"10.1007\/978-81-322-3664-1"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"324","DOI":"10.4103\/psychiatry.IndianJPsychiatry_115_16","article-title":"Cross-sectional study of psychiatric morbidity in patients with melasma","volume":"60","author":"Deshpande","year":"2018","journal-title":"Indian J. Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1590\/abd1806-4841.20143063","article-title":"Melasma: A clinical and epidemiological review","volume":"89","author":"Handel","year":"2014","journal-title":"An. Bras. de Dermatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1080\/09546630601028778","article-title":"Melasma and its impact on health-related quality of life in Hispanic women","volume":"18","author":"Pawaskar","year":"2007","journal-title":"J. Dermatol. Treat."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1111\/jdv.15987","article-title":"Psychological disturbances in patients with pigmentary disorders: A cross-sectional study","volume":"34","author":"Dabas","year":"2020","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"184","DOI":"10.36849\/JDD.2020.4663","article-title":"Melasma\u2019s Impact on Quality of Life","volume":"19","author":"Kagha","year":"2020","journal-title":"J. Drugs Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1590\/abd1806-4841.20152771","article-title":"Melasma and assessment of the quality of life in Brazilian women","volume":"90","author":"Ikino","year":"2015","journal-title":"An. Bras. Dermatol."},{"key":"ref_17","first-page":"21","article-title":"The Effect of Melasma on the Quality of Life in a Sample of Women Living in Singapore","volume":"9","author":"Harumi","year":"2016","journal-title":"J. Clin. Aesthetic Dermatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1590\/abd1806-4841.20186780","article-title":"Development and validation of a multidimensional questionnaire for evaluating quality of life in melasma (HRQ-melasma)","volume":"93","author":"Pollo","year":"2018","journal-title":"An. Bras. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.det.2011.11.009","article-title":"Melasma Quality of Life Measures","volume":"30","author":"Lieu","year":"2012","journal-title":"Dermatol. Clin."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1046\/j.1365-2133.2003.05419.x","article-title":"Development and validation of a health-related quality of life instrument for women with melasma","volume":"149","author":"Balkrishnan","year":"2003","journal-title":"Br. J. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1111\/pcmr.12404","article-title":"Recent progress in melasma pathogenesis","volume":"28","author":"Lee","year":"2015","journal-title":"Pigment Cell Melanoma Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1038\/jid.2011.109","article-title":"Transcriptional profiling shows altered expression of Wnt Pathway\u2013 and lipid Metabolism\u2013Related genes as well as melanogenesis-related genes in melasma","volume":"131","author":"Kang","year":"2011","journal-title":"J. Investig. Dermatol."},{"key":"ref_23","unstructured":"Burgdorf, W.H.C., Plewig, G., Wolff, H.H., Gli\u0144ski, W., Czarnecka-Operacz, M., Krasowska, D., Serwin, A., and Wolska, H. (2017). Dermatologia Braun-Falco, Volume II, Czelej. [3rd ed.]."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1046\/j.0007-0963.2001.04556.x","article-title":"Melasma: Histopathological characteristics in 56 Korean patients","volume":"146","author":"Kang","year":"2002","journal-title":"Br. J. Dermatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1111\/j.1365-2230.2008.02724.x","article-title":"Solar elastosis and presence of mast cells as key features in the pathogenesis of melasma","volume":"33","author":"Moncada","year":"2008","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1097\/DAD.0b013e3181ef2d45","article-title":"Histochemical and Immunohistochemical Study in Melasma: Evidence of Damage in the Basal Membrane","volume":"33","author":"Moncada","year":"2011","journal-title":"Am. J. Dermatopathol."},{"key":"ref_27","unstructured":"Burgdorf, W.H.C., Plewig, G., Wolff, H.H., Gli\u0144ski, W., Czarnecka-Operacz, M., Krasowska, D., Serwin, A., and Wolska, H. (2017). Dermatologia Braun-Falco, Volume III, Czelej. [3rd ed.]."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"S100","DOI":"10.1111\/1523-1747.ep12874944","article-title":"Evidence for an Epidermal Cytokine Network","volume":"95","author":"Luger","year":"1990","journal-title":"J. Investig. Dermatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/1523-1747.ep12471536","article-title":"Stimulatory effect of prostaglandin e2 on the configuration of normal human melanocytes in vitro","volume":"89","author":"Tomita","year":"1987","journal-title":"J. Investig. Dermatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1111\/1523-1747.ep12312500","article-title":"Endothelin-1 as a new melanogen: Coordinated expression of its gene and the tyrosinase gene in UVB-Exposed human epidermis","volume":"105","author":"Imokawa","year":"1995","journal-title":"J. Investig. Dermatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1007\/BF00371837","article-title":"Expression of different immunological markers by cultured human melanocytes, Archives of Dermatological Research","volume":"285","author":"Smit","year":"1993","journal-title":"Arch. Dermatol. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2258","DOI":"10.1172\/JCI117224","article-title":"Proopiomelanocortin-derived peptides are synthesized and released by human keratinocytes","volume":"93","author":"Schauer","year":"1994","journal-title":"J. Clin. Investig."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/S0190-9622(81)70071-9","article-title":"Melasma: A clinical, light microscopic, ultrastructural, and immunofluorescence study","volume":"4","author":"Sanchez","year":"1981","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/01.dad.0000154419.18653.2e","article-title":"Light microscopic, immunohistochemical, and ultrastructural alterations in patients with melasma","volume":"27","author":"Grimes","year":"2005","journal-title":"Am. J. Dermatopathol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"695","DOI":"10.5604\/17322693.1208033","article-title":"From tyrosine to melanin: Signaling pathways and factors regulating melanogenesis","volume":"70","author":"Rzepka","year":"2016","journal-title":"Postepy Hig. I Med. Dosw. (Online)"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/0022-202X(89)90177-2","article-title":"UVB-Induced melanogenesis may be mediated through the MSH-Receptor system","volume":"92","author":"Bolognia","year":"1989","journal-title":"J. Investig. Dermatol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1111\/exd.13814","article-title":"Senescent fibroblasts in melasma pathophysiology","volume":"28","author":"Kim","year":"2019","journal-title":"Exp. Dermatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1111\/exd.12066","article-title":"Azelaic acid reduced senescence-like phenotype in photo-irradiated human dermal fibroblasts: Possible implication of PPAR\u03b3","volume":"22","author":"Briganti","year":"2013","journal-title":"Exp. Dermatol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1111\/j.1600-0625.2012.01483.x","article-title":"siRNA-mediated knock-down of COX-2 in melanocytes suppresses melanogenesis","volume":"21","author":"Kim","year":"2012","journal-title":"Exp. Dermatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"103871","DOI":"10.1016\/j.isci.2022.103871","article-title":"Sebocytes contribute to melasma onset","volume":"25","author":"Flori","year":"2022","journal-title":"iScience"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1111\/j.1600-0625.2012.01468.x","article-title":"SZ95 sebocytes induce epidermal melanocyte dendricity and proliferation in vitro","volume":"21","author":"Seltmann","year":"2012","journal-title":"Exp. Dermatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"3432","DOI":"10.1111\/jocd.14382","article-title":"The pathogenesis of melasma and implications for treatment","volume":"20","author":"Artzi","year":"2021","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1590\/S0365-05962013000100009","article-title":"Mechanisms regulating melanogenesis","volume":"88","author":"Videira","year":"2013","journal-title":"An. Bras. De Dermatol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1046\/j.1365-2133.2003.05113.x","article-title":"The effect of ultraviolet radiation exposure on the prevalence of mast cells in human skin","volume":"148","author":"Grimbaldeston","year":"2003","journal-title":"Br. J. Dermatol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s00403-007-0806-1","article-title":"Mast cell tryptase and photoaging: Possible involvement in the degradation of extra cellular matrix and basement membrane proteins","volume":"300","author":"Iddamalgoda","year":"2008","journal-title":"Arch. Dermatol. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.canlet.2008.03.031","article-title":"Mast cells and tumour angiogenesis: New insight from experimental carcinogenesis","volume":"269","author":"Crivellato","year":"2008","journal-title":"Cancer Lett."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/acel.12298","article-title":"Granzyme B mediates both direct and indirect cleavage of extracellular matrix in skin after chronic low-dose ultraviolet light irradiation","volume":"14","author":"Parkinson","year":"2015","journal-title":"Aging Cell"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1046\/j.1523-1747.2000.00874.x","article-title":"Histamine induces melanogenesis and morphologic changes by protein kinase a activation via H2 receptors in human normal melanocytes","volume":"114","author":"Yoshida","year":"2000","journal-title":"J. Investig. Dermatol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1111\/1523-1747.ep12346356","article-title":"Histamine in Human Epidermal Cells is Induced by Ultraviolet Light Injury","volume":"106","author":"Malaviya","year":"1996","journal-title":"J. Investig. Dermatol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.jdermsci.2007.01.009","article-title":"The vascular characteristics of melasma","volume":"46","author":"Kim","year":"2007","journal-title":"J. Dermatol. Sci."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"3096","DOI":"10.1038\/jid.2015.332","article-title":"Endothelial Cells Promote Pigmentation through Endothelin Receptor B Activation","volume":"135","author":"Regazzetti","year":"2015","journal-title":"J. Investig. Dermatol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/S0190-9622(87)80279-7","article-title":"Melasma occurring in twin sisters","volume":"17","author":"Hughes","year":"1987","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1111\/j.1468-3083.2009.03295.x","article-title":"A global survey of the role of ultraviolet radiation and hormonal influences in the development of melasma","volume":"23","author":"Ortonne","year":"2009","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/j.1468-3083.2011.04430.x","article-title":"Clinical patterns and epidemiological characteristics of facial melasma in Brazilian women","volume":"27","author":"Tamega","year":"2013","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1111\/j.1755-148X.2009.00659.x","article-title":"H19 RNA downregulation stimulated melanogenesis in melasma","volume":"23","author":"Kim","year":"2010","journal-title":"Pigment. Cell Melanoma Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"867.e1","DOI":"10.1016\/j.jaad.2013.08.022","article-title":"Photoprotection: Part II. Sunscreen: Development, efficacy, and controversies","volume":"69","author":"Jansen","year":"2013","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"211","DOI":"10.17219\/acem\/132069","article-title":"Wharton\u2019s jelly-derived mesenchymal stem cells in the treatment of four patients with alopecia areata","volume":"30","author":"Czarnecka","year":"2021","journal-title":"Adv. Clin. Exp. Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"3723","DOI":"10.31557\/APJCP.2019.20.12.3723","article-title":"The Role of Stem Cell Factor in Hyperpigmented Skin Lesions","volume":"20","author":"Atef","year":"2019","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"272","DOI":"10.3109\/09546630903341945","article-title":"Hydroquinone for skin lightening: Safety profile, duration of use and when should we stop?","volume":"21","author":"Tse","year":"2010","journal-title":"J. Dermatol. Treat."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1111\/j.1473-2165.2007.00288.x","article-title":"A comparison of triple combination cream and hydroquinone 4% cream for the treatment of moderate to severe facial melasma","volume":"6","author":"Cestari","year":"2007","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1016\/j.jaad.2006.02.009","article-title":"The treatment of melasma: A review of clinical trials","volume":"55","author":"Gupta","year":"2006","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_62","first-page":"67","article-title":"Efficacy and safety of a new triple-combination agent for the treatment of facial melasma","volume":"72","author":"Taylor","year":"2003","journal-title":"Cutis"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s40261-015-0292-8","article-title":"Efficacy and safety of fluocinolone acetonide, hydroquinone, and tretinoin cream in Chinese patients with melasma: A randomized, double-blind, placebo-controlled, multicenter, parallel-group study","volume":"35","author":"Gong","year":"2015","journal-title":"Clin. Drug Investig."},{"key":"ref_64","first-page":"697","article-title":"A randomized controlled trial of the efficacy and safety of a fixed triple combination (fluocinolone acetonide 001, hydroquinone 4, tretinoin 005) compared with hydroquinone 4 cream in Asian patients with moderate to severe melasma","volume":"159","author":"Chan","year":"2008","journal-title":"Br. J. Dermatol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1034\/j.1600-0749.2003.00029.x","article-title":"Chemical and Instrumental Approaches to Treat Hyperpigmentation","volume":"16","author":"Briganti","year":"2003","journal-title":"Pigment Cell Res."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1111\/j.1473-2165.2005.40202.x","article-title":"Hydroquinone and its analogues in dermatology-A potential health risk","volume":"4","author":"Westerhof","year":"2005","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"8","DOI":"10.4103\/ijdvl.IJDVL_633_18","article-title":"Future therapies in melasma: What lies ahead?","volume":"86","author":"Sarkar","year":"2020","journal-title":"Indian J. Dermatol. Venereol. Leprol."},{"key":"ref_68","first-page":"S1545961619P1156X","article-title":"Topical Treatments for Melasma: A Systematic Review of Randomized Controlled Trials","volume":"18","author":"Austin","year":"2019","journal-title":"J. Drugs Dermatol. JDD"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s40257-019-00488-w","article-title":"Melasma Treatment: An Evidence-Based Review","volume":"21","author":"McKesey","year":"2020","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1111\/j.1529-8019.2006.00085.x","article-title":"Retinoid therapy of pigmentary disorders","volume":"19","author":"Ortonne","year":"2006","journal-title":"Dermatol. Ther."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1242\/jcs.107.4.1095","article-title":"Retinoic acid as modulator of UVB-induced melanocyte differentiation. Involvement of the melanogenic enzymes expression","volume":"107","author":"Romero","year":"1994","journal-title":"J. Cell Sci."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1111\/j.1365-2133.1993.tb03169.x","article-title":"Topical tretinoin (retinoic acid) improves melasma. A vehicle-controlled, clinical trial","volume":"129","author":"Griffiths","year":"1993","journal-title":"Br. J. Dermatol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"S17","DOI":"10.1016\/S0190-9622(98)70440-2","article-title":"Pharmacodynamics and pharmacokinetics of topical adapalene","volume":"39","author":"Shroot","year":"1998","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_74","first-page":"868","article-title":"Topical isotretinoin for melasma in Thai patients: A vehicle-controlled clinical trial","volume":"82","author":"Leenutaphong","year":"1999","journal-title":"J. Med. Assoc. Thail."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"776","DOI":"10.2340\/00015555-2668","article-title":"Efficacy and Safety of Tranexamic Acid in Melasma: A Meta-analysis and Systematic Review","volume":"97","author":"Kim","year":"2017","journal-title":"Acta Derm. Venereol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1097\/DSS.0000000000001518","article-title":"Oral Tranexamic Acid for the Treatment of Melasma: A Review","volume":"44","author":"Bala","year":"2018","journal-title":"Dermatol. Surg."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"40","DOI":"10.3126\/kumj.v10i4.10993","article-title":"Oral tranexamic acid for the treatment of melasma","volume":"10","author":"Karn","year":"2012","journal-title":"Kathmandu Univ. Med. J."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1248\/jhs.53.389","article-title":"Mechanism of the Inhibitory Effect of Tranexamic Acid on Melanogenesis in Cultured Human Melanocytes in the Presence of Keratinocyte-conditioned Medium","volume":"53","author":"Maeda","year":"2007","journal-title":"J. Health Sci."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1111\/jocd.13430","article-title":"Study of oral tranexamic acid, topical tranexamic acid, and modified Kligman\u2019s regimen in treatment of melasma","volume":"19","author":"Sahu","year":"2020","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1007\/s00266-012-9899-9","article-title":"Treatment of melasma with oral administration of tranexamic acid","volume":"36","author":"Wu","year":"2012","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"e105","DOI":"10.1111\/ajd.12474","article-title":"Oral tranexamic acid lightens refractory melasma","volume":"58","author":"Tan","year":"2017","journal-title":"Australas. J. Dermatol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.jaad.2016.03.001","article-title":"Oral tranexamic acid (TA) in the treatment of melasma: A retrospective analysis","volume":"75","author":"Lee","year":"2016","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1111\/jocd.13615","article-title":"Isobutylamido thiazolyl resorcinol for prevention of UVB-induced hyperpigmentation","volume":"20","author":"Vachiramon","year":"2021","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1111\/jdv.17344","article-title":"Efficacy and safety of topical isobutylamido thiazolyl resorcinol (Thiamidol) vs. 4% hydroquinone cream for facial melasma: An evaluator-blinded, randomized controlled trial","volume":"35","author":"Lima","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1016\/j.jid.2019.02.013","article-title":"Effective Tyrosinase Inhibition by Thiamidol Results in Significant Improvement of Mild to Moderate Melasma","volume":"139","author":"Arrowitz","year":"2019","journal-title":"J. Investig. Dermatol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1871","DOI":"10.1111\/1346-8138.16080","article-title":"Thiamidol \u00ae in moderate-to-severe melasma: 24-week, randomized, double-blind, vehicle-controlled clinical study with subsequent regression phase","volume":"48","author":"Roggenkamp","year":"2021","journal-title":"J. Dermatol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"417","DOI":"10.4103\/0378-6323.98071","article-title":"Newer and upcoming therapies for melasma","volume":"78","author":"Sarkar","year":"2012","journal-title":"Indian J. Dermatol. Venereol. Leprol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1111\/dsu.12296","article-title":"Is Topical Zinc Effective in the Treatment of Melasma? A Double-Blind Randomized Comparative Study","volume":"40","author":"Yousefi","year":"2014","journal-title":"Dermatol. Surg."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"4","DOI":"10.4103\/0974-2077.110089","article-title":"Cosmeceuticals for hyperpigmentation: What is available?","volume":"6","author":"Sarkar","year":"2013","journal-title":"J. Cutan. Aesthetic Surg."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"74","DOI":"10.2310\/7750.2008.07092","article-title":"Clinical Efficacy of 25% l-Ascorbic Acid (C\u2019ensil) in the Treatment of Melasma","volume":"13","author":"Hwang","year":"2009","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_91","first-page":"1346","article-title":"Topical 10% Zinc Sulfate Solution for Treatment of Melasma","volume":"34","author":"Sharquie","year":"2008","journal-title":"Dermatol. Surg."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"170","DOI":"10.5142\/jgr.2011.35.2.170","article-title":"Korean Red Ginseng Powder in the Treatment of Melasma: An Uncontrolled Observational Study","volume":"35","author":"Song","year":"2011","journal-title":"J. Ginseng Res."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1111\/j.1346-8138.2010.00897.x","article-title":"Whitening efficacy of plant extracts including orchid extracts on Japanese female skin with melasma and lentigo senilis","volume":"37","author":"Tadokoro","year":"2010","journal-title":"J. Dermatol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/HNP.0000000000000186","article-title":"The Effect of Topical Use of Petroselinum Crispum (Parsley) Versus That of Hydroquinone Cream on Reduction of Epidermal Melasma: A Randomized Clinical Trial","volume":"31","author":"Khosravan","year":"2017","journal-title":"Holist. Nurs. Pract."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1002\/ptr.1085","article-title":"Treatment of melasma with Pycnogenol\u00ae","volume":"16","author":"Ni","year":"2002","journal-title":"Phytotherapy Res."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1111\/ijd.15133","article-title":"Treatment of melasma: A review of less commonly used antioxidants","volume":"60","author":"Babbush","year":"2021","journal-title":"Int. J. Dermatol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1038\/mt.2010.263","article-title":"MITF-siRNA Formulation Is a Safe and Effective Therapy for Human Melasma","volume":"19","author":"Yi","year":"2011","journal-title":"Mol. Ther."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"2589","DOI":"10.1038\/jid.2014.202","article-title":"Inhibition of Melanogenesis by the Antidiabetic Metformin","volume":"134","author":"Lehraiki","year":"2014","journal-title":"J. Investig. Dermatol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1038\/jid.2014.461","article-title":"Omeprazole, a Gastric Proton Pump Inhibitor, Inhibits Melanogenesis by Blocking ATP7A Trafficking","volume":"135","author":"Matsui","year":"2015","journal-title":"J. Investig. Dermatol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"265","DOI":"10.3109\/14764172.2011.630088","article-title":"Melasma: Treatment strategy","volume":"13","author":"Sehgal","year":"2011","journal-title":"J. Cosmet. Laser Ther."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1111\/j.1524-4725.2012.02435.x","article-title":"Advances in the Treatment of Melasma: A Review of the Recent Literature","volume":"38","author":"Arefiev","year":"2012","journal-title":"Dermatol. Surg."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"21","DOI":"10.2147\/CCID.S89451","article-title":"Assessment of efficacy, safety, and tolerability of 4-n-butylresorcinol 0.3% cream: An Indian multicentric study on melasma","volume":"9","author":"Shamanna","year":"2016","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1111\/jocd.13080","article-title":"Efficacy of liposome-encapsulated 4-n-butylresorcinol and resveratrol cream in the treatment of melasma","volume":"19","author":"Kwon","year":"2020","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1111\/j.1346-8138.2010.00787.x","article-title":"Efficacy and safety of liposome-encapsulated 4-n-butylresorcinol 0.1% cream for the treatment of melasma: A randomized controlled split-face trial","volume":"37","author":"Huh","year":"2010","journal-title":"J. Dermatol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1111\/j.1365-2133.2007.07814.x","article-title":"Evaluation of efficacy and safety of rucinol serum in patients with melasma: A randomized controlled trial","volume":"156","author":"Khemis","year":"2007","journal-title":"Br. J. Dermatol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1111\/jocd.12147","article-title":"A double-blind, placebo-controlled randomized trial of Serratulae quinquefoliae folium, a new source of \u03b2-arbutin, in selected skin hyperpigmentations","volume":"14","author":"Morag","year":"2015","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1111\/j.1365-4632.2004.02134.x","article-title":"A double-blind randomized trial of 5% ascorbic acid vs. 4% hydroquinone in melasma","volume":"43","author":"Moncada","year":"2004","journal-title":"Int. J. Dermatol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1159\/000069943","article-title":"A Randomized, Double-Blind, Placebo-Controlled Trial of Vitamin C Iontophoresis in Melasma","volume":"206","author":"Huh","year":"2003","journal-title":"Dermatology"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1111\/j.1365-4362.1991.tb04362.x","article-title":"The Treatment of Melasma 20% Azelaic Acid versus 4% Hydroquinone Cream","volume":"30","author":"Graupe","year":"1991","journal-title":"Int. J. Dermatol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1111\/j.1473-2165.2011.00580.x","article-title":"Comparative study of therapeutic effects of 20% azelaic acid and hydroquinone 4% cream in the treatment of melasma","volume":"10","author":"Farshi","year":"2011","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1111\/jocd.12217","article-title":"Comparison of efficacy of products containing azelaic acid in melasma treatment","volume":"15","author":"Mazurek","year":"2016","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_112","first-page":"58","article-title":"Double-blind comparison of azelaic acid and hydroquinone in the treatment of melasma","volume":"143","author":"Verallo","year":"1989","journal-title":"Acta Derm.-Venereologica. Suppl."},{"key":"ref_113","first-page":"40","article-title":"Evaluating the Efficacy, Safety, and Tolerability of the Combination of Tazarotene, Azelaic Acid, Tacrolimus, and Zinc Oxide for the Treatment of Melasma: A Pilot Study","volume":"12","author":"Kirsch","year":"2019","journal-title":"J. Clin. Aesthetic Dermatol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1111\/bjd.13424","article-title":"Evaluation of the efficacy of cysteamine 5% cream in the treatment of epidermal melasma: A randomized double-blind placebo-controlled trial","volume":"173","author":"Mansouri","year":"2015","journal-title":"Br. J. Dermatol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1111\/j.1365-4632.2009.04105.x","article-title":"Efficacy of dioic acid compared with hydroquinone in the treatment of melasma","volume":"48","year":"2009","journal-title":"Int. J. Dermatol."},{"key":"ref_116","first-page":"4219","article-title":"The first clinical experience on efficacy of topical flutamide on melasma compared with topical hydroquinone: A randomized clinical trial","volume":"9","author":"Adalatkhah","year":"2015","journal-title":"Drug Des. Dev. Ther."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.mehy.2017.01.020","article-title":"Melasma treatment: A novel approach using a topical agent that contains an anti-estrogen and a vascular endothelial growth factor inhibitor","volume":"101","author":"Cohen","year":"2017","journal-title":"Med. Hypotheses"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1097\/DSS.0000000000000642","article-title":"Comparative Evaluation of Efficacy and Tolerability of Glycolic Acid, Salicylic Mandelic Acid, and Phytic Acid Combination Peels in Melasma","volume":"42","author":"Sarkar","year":"2016","journal-title":"Dermatol. Surg."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"e14693","DOI":"10.1111\/dth.14693","article-title":"Most worthwhile superficial chemical peel for melasma of skin of color: Authors\u2019 experience of glycolic, trichloroacetic acid, and lactic peel","volume":"34","author":"Sahu","year":"2021","journal-title":"Dermatol. Ther."},{"key":"ref_120","first-page":"1149","article-title":"Efficacy of combination of glycolic acid peeling with topical regimen in treatment of melasma","volume":"12","author":"Chaudhary","year":"2013","journal-title":"J. Drugs Dermatol."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1046\/j.1524-4725.1999.08236.x","article-title":"Fams Treatment of Melasma Using Kojic Acid in a Gel Containing Hydroquinone and Glycolic Acid","volume":"25","author":"Lim","year":"1999","journal-title":"Dermatol. Surg."},{"key":"ref_122","first-page":"756","article-title":"Tretinoin Peels versus Glycolic Acid Peels in the Treatment of Melasma in Dark-Skinned Patients","volume":"30","author":"Khunger","year":"2004","journal-title":"Dermatol. Surg."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1007\/s00105-020-04712-1","article-title":"Chemical Peelings zur Behandlung von Melasma, Pigmentst\u00f6rungen und Hyperpigmentierungen","volume":"71","author":"Borelli","year":"2020","journal-title":"Der. Hautarzt"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1001\/archderm.138.12.1578","article-title":"Efficacy of glycolic acid peels in the treatment of melasma","volume":"138","author":"Hurley","year":"2002","journal-title":"Arch. Dermatol."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1111\/j.1524-4725.2010.01481.x","article-title":"Glycolic acid peels versus amino fruit acid peels in the treatment of melasma","volume":"36","author":"Ilknur","year":"2010","journal-title":"Dermatol. Surg."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"447","DOI":"10.4103\/0378-6323.66602","article-title":"Comparative study of trichloroacetic acid versus glycolic acid chemical peels in the treatment of melasma","volume":"76","author":"Thappa","year":"2010","journal-title":"Indian J. Dermatol. Venereol. Leprol."},{"key":"ref_127","first-page":"1439","article-title":"Comparison between 1% tretinoin peeling versus 70% glycolic acid peeling in the treatment of female patients with melasma","volume":"10","author":"Faghihi","year":"2011","journal-title":"J. Drugs Dermatol."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/j.1346-8138.2007.00211.x","article-title":"Efficacy and safety of serial glycolic acid peels and a topical regimen in the treatment of recalcitrant melasma","volume":"34","author":"Erbil","year":"2007","journal-title":"J. Dermatol."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/jocd.12260","article-title":"Combination of glycolic acid peel and topical 20% azelaic acid cream in melasma patients: Efficacy and improvement in quality of life","volume":"16","author":"Dayal","year":"2017","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1080\/09546630050517333","article-title":"A double-blind, comparative, placebo-controlled study of the efficacy and tolerability of 4% hydroquinone as a depigmenting agent in melasma","volume":"11","author":"Ennes","year":"2000","journal-title":"J. Dermatol. Treat."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1111\/j.1365-4632.2003.02017.x","article-title":"Safety and efficacy of 4% hydroquinone combined with 10% glycolic acid, antioxidants, and sunscreen in the treatment of melasma","volume":"42","author":"Guevara","year":"2003","journal-title":"Int. J. Dermatol."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"157","DOI":"10.4103\/0019-5154.108070","article-title":"A comparative study of the efficacy of 4% hydroquinone vs 0.75% Kojic acid cream in the treatment of facial melasma","volume":"58","author":"Monteiro","year":"2013","journal-title":"Indian J. Dermatol."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"281","DOI":"10.4103\/0019-5154.113940","article-title":"Kojic acid vis-a-vis its combinations with hydroquinone and betamethasone valerate in melasma: A randomized, single blind, comparative study of efficacy and safety","volume":"58","author":"Deo","year":"2013","journal-title":"Indian J. Dermatol."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1007\/s004030050320","article-title":"Linoleic acid and \u03b1-linolenic acid lightens ultraviolet-induced hyperpigmentation of the skin","volume":"290","author":"Ando","year":"1998","journal-title":"Arch. Dermatol. Res."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1111\/j.0022-202X.2004.22509.x","article-title":"Methimazole Is an Inhibitor of Melanin Synthesis in Cultured B16 Melanocytes","volume":"122","author":"Kasraee","year":"2004","journal-title":"J. Investig. Dermatol."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/jocd.12987","article-title":"The efficacy and safety of topical 5% methimazole vs 4% hydroquinone in the treatment of melasma: A randomized controlled trial","volume":"19","author":"Gheisari","year":"2020","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_137","first-page":"379173","article-title":"A Double-Blind, Randomized Clinical Trial of Niacinamide 4% versus Hydroquinone 4% in the Treatment of Melasma","volume":"2011","author":"Moncada","year":"2011","journal-title":"Dermatol. Res. Pract."},{"key":"ref_138","first-page":"28","article-title":"Dual Effect of Photobiomodulation on Melasma: Downregulation of Hyperpigmentation and Enhanced Solar Resistance-A Pilot Study","volume":"11","author":"Barolet","year":"2018","journal-title":"J. Clin. Aesthetic Dermatol."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1111\/jdv.16896","article-title":"French maritime pine bark extract (pycnogenol) in association with triple combination cream for the treatment of facial melasma in women: A double-blind, randomized, placebo-controlled trial","volume":"35","author":"Lima","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"251","DOI":"10.2165\/00128071-200910040-00005","article-title":"The Role of Topical Retinoids in the Treatment of Pigmentary Disorders","volume":"10","author":"Kang","year":"2009","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1111\/j.1473-2165.2010.00488.x","article-title":"Melasma: Treatment with 10% tretinoin peeling mask","volume":"9","author":"Ghersetich","year":"2010","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1001\/archderm.1994.01690060057005","article-title":"Topical retinoic acid (tretinoin) for melasma in black patients: A vehicle-controlled clinical trial","volume":"130","author":"Griffiths","year":"1994","journal-title":"Arch. Dermatol."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1111\/jocd.12110","article-title":"Assessment of the efficacy and tolerance of a new combination of retinoids and depigmenting agents in the treatment of melasma","volume":"13","author":"Truchuelo","year":"2014","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1111\/j.1346-8138.2002.tb00324.x","article-title":"Adapalene in the treatment of melasma: A preliminary report","volume":"29","author":"Dogra","year":"2002","journal-title":"J. Dermatol."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1159\/000247129","article-title":"Treatment of Melasma with Potent Topical Corticosteroids","volume":"188","author":"Kanwar","year":"1994","journal-title":"Dermatology"},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1111\/jocd.13628","article-title":"Efficacy and safety of intralesional steroid injection in the treatment of melasma","volume":"20","author":"Nassar","year":"2021","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_147","first-page":"67","article-title":"Comparison between Intralesional Triamcinolone and Kligman\u2019s Formula in Treatment of Melasma","volume":"54","author":"Eshghi","year":"2016","journal-title":"Acta MEDICA Iran."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1111\/jocd.12769","article-title":"Topical silymarin versus hydroquinone in the treatment of melasma: A comparative study","volume":"18","author":"Nofal","year":"2019","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-5945-12-18","article-title":"The treatment of melasma by silymarin cream","volume":"12","author":"Altaei","year":"2012","journal-title":"BMC Dermatol."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/ics.12626","article-title":"Thiamidol containing treatment regimens in facial hyperpigmentation: An international multi-centre approach consisting of a double-blind, controlled, split-face study and of an open-label, real-world study","volume":"42","author":"Damonte","year":"2020","journal-title":"Int. J. Cosmet. Sci."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"e102","DOI":"10.1097\/DSS.0000000000002449","article-title":"Tranexamic Acid for Melasma Treatment: A Split-Face Study","volume":"46","author":"Ebrahim","year":"2020","journal-title":"Dermatol. Surg."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"63","DOI":"10.4103\/JCAS.JCAS_40_18","article-title":"A Randomized Controlled Study Comparing the Efficacy of Topical 5% Tranexamic Acid Solution versus 3% Hydroquinone Cream in Melasma","volume":"12","author":"Janney","year":"2019","journal-title":"J. Cutan. Aesthetic Surg."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s13555-017-0195-0","article-title":"Therapeutic Effects of Topical Tranexamic Acid in Comparison with Hydroquinone in Treatment of Women with Melasma","volume":"7","author":"Atefi","year":"2017","journal-title":"Dermatol. Ther."},{"key":"ref_154","first-page":"36","article-title":"Intradermal Tranexamic Acid Injection for the Treatment of Melasma: A Pilot Study with 48-week Follow-up","volume":"13","author":"Lueangarun","year":"2020","journal-title":"J. Clin. Aesthetic Dermatol."},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1111\/jocd.12152","article-title":"Comparison of therapeutic effects of liposomal Tranexamic Acid and conventional Hydroquinone on melasma","volume":"14","author":"Banihashemi","year":"2015","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1080\/14764172.2018.1427869","article-title":"Topical 3% tranexamic acid enhances the efficacy of 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser in the treatment of melasma","volume":"20","author":"Laothaworn","year":"2018","journal-title":"J. Cosmet. Laser Ther."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"e6897","DOI":"10.1097\/MD.0000000000006897","article-title":"Efficacy of functional microarray of microneedles combined with topical tranexamic acid for melasma: A randomized, self-controlled, split-face study, Medicine (Baltimore)","volume":"96","author":"Xu","year":"2017","journal-title":"Medicine"},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1080\/09546634.2017.1392476","article-title":"Comparing the efficacy of topical hydroquinone 2% versus intradermal tranexamic acid microinjections in treating melasma: A split-face controlled trial","volume":"29","author":"Saki","year":"2017","journal-title":"J. Dermatol. Treat."},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"8350317","DOI":"10.1155\/2018\/8350317","article-title":"Evaluation of Therapeutic Efficacy and Safety of Tranexamic Acid Local Infiltration in Combination with Topical 4% Hydroquinone Cream Compared to Topical 4% Hydroquinone Cream Alone in Patients with Melasma: A Split-Face Study","volume":"2018","author":"Tehranchinia","year":"2018","journal-title":"Dermatol. Res. Pract."},{"key":"ref_160","first-page":"174","article-title":"Study evaluating the efficacy of topical and injected tranexamic acid in treatment of melasma, Surgical and Cosmetic Dermatology","volume":"1","author":"Steiner","year":"2009","journal-title":"Surg. Cosmet. Dermatol."},{"key":"ref_161","doi-asserted-by":"crossref","first-page":"139","DOI":"10.4103\/0974-2077.118403","article-title":"A randomised, open-label, comparative study of tranexamic acid microinjections and tranexamic acid with microneedling in patients with melasma","volume":"6","author":"Budamakuntla","year":"2013","journal-title":"J. Cutan. Aesthetic Surg."},{"key":"ref_162","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1111\/ced.13164","article-title":"Therapeutic efficacy and safety of oral tranexamic acid and that of tranexamic acid local infiltration with microinjections in patients with melasma: A comparative study","volume":"42","author":"Sharma","year":"2017","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_163","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/j.1473-2165.2007.00302.x","article-title":"Combined trichloroacetic acid peel and topical ascorbic acid versus trichloroacetic acid peel alone in the treatment of melasma: A comparative study","volume":"6","author":"Soliman","year":"2007","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_164","doi-asserted-by":"crossref","first-page":"e179","DOI":"10.1097\/DSS.0000000000002964","article-title":"Modified Jessner\u2019s Solution Combined with Trichloroacetic Acid 20% Versus Glycolic Acid 70% Combined with Trichloroacetic Acid 20% in the Treatment of Melasma","volume":"47","author":"Helmy","year":"2021","journal-title":"Dermatol. Surg."},{"key":"ref_165","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1097\/DSS.0000000000001036","article-title":"Combined Jessner Solution and Trichloroacetic Acid versus Trichloroacetic Acid Alone in the Treatment of Melasma in Dark-Skinned Patients","volume":"43","author":"Taha","year":"2017","journal-title":"Dermatol. Surg."},{"key":"ref_166","first-page":"557","article-title":"Efficacy of Trichloro-Acetic Acid Peel Alone Versus Combined Topical Magnesium Ascorbyl Phosphate for Epidermal Melasma","volume":"26","author":"Murtaza","year":"2016","journal-title":"J. Coll. Physicians Surg. Pak."},{"key":"ref_167","first-page":"592","article-title":"A large 12-month extension study of an 8-week trial to evaluate the safety and efficacy of triple combination (TC) cream in melasma patients previously treated with TC cream or one of its dyads","volume":"4","author":"Torok","year":"2005","journal-title":"J. Drugs Dermatol."},{"key":"ref_168","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1111\/j.1468-3083.2011.04135.x","article-title":"Preventing melasma recurrence: Prescribing a maintenance regimen with an effective triple combination cream based on long-standing clinical severity","volume":"26","author":"Arellano","year":"2012","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_169","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1016\/j.jaad.2009.06.067","article-title":"Continuous therapy followed by a maintenance therapy regimen with a triple combination cream for melasma","volume":"62","author":"Grimes","year":"2010","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_170","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1111\/j.1524-4725.2005.31035","article-title":"Lactic Acid as a New Therapeutic Peeling Agent in Melasma","volume":"31","author":"Sharquie","year":"2006","journal-title":"Dermatol. Surg."},{"key":"ref_171","first-page":"1429","article-title":"Lactic Acid Chemical Peels as a New Therapeutic Modality in Melasma in Comparison to Jessner\u2019s Solution Chemical Peels","volume":"32","author":"Sharquie","year":"2006","journal-title":"Dermatol. Surg."},{"key":"ref_172","first-page":"526","article-title":"Clinical and Instrumental Evaluation of Skin Improvement after Treatment with a New 50% Pyruvic Acid Peel","volume":"32","author":"Berardesca","year":"2006","journal-title":"Dermatol. Surg."},{"key":"ref_173","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1080\/14764172.2017.1314501","article-title":"Salicylic acid peeling combined with vitamin C mesotherapy versus salicylic acid peeling alone in the treatment of mixed type melasma: A comparative study","volume":"19","author":"Balevi","year":"2017","journal-title":"J. Cosmet. Laser Ther."},{"key":"ref_174","unstructured":"(2020). Chemical peeling for acne and melasma: Current knowledge and innovations. G. Ital. Di Dermatol. E Venereol., 155, 280\u2013285."},{"key":"ref_175","first-page":"1","article-title":"Effect of 82% Lactic Acid in Treatment of Melasma","volume":"2014","author":"Singh","year":"2014","journal-title":"Int. Sch. Res. Not."},{"key":"ref_176","first-page":"4","article-title":"Enhancing cosmetic outcomes by combining superficial glycolic acid (alpha-hydroxy acid) peels with nonablative lasers, intense pulsed light, and trichloroacetic acid peels","volume":"79","author":"Effron","year":"2007","journal-title":"Cutis"},{"key":"ref_177","doi-asserted-by":"crossref","first-page":"S159","DOI":"10.1016\/S0151-9638(12)70129-1","article-title":"Lasers","volume":"139","author":"Passeron","year":"2012","journal-title":"Ann. Dermatol. V\u00e9n\u00e9r\u00e9ologie"},{"key":"ref_178","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1111\/j.1524-4725.2011.01971.x","article-title":"Laser Eradication of Pigmented Lesions: A Review","volume":"37","author":"Polder","year":"2011","journal-title":"Dermatol. Surg."},{"key":"ref_179","first-page":"920","article-title":"Laserbehandlung von Pigmentst\u00f6rungen","volume":"71","author":"Fritz","year":"2020","journal-title":"Der Hautarzt; Z. Fur Dermatol. Venerol. Und Verwandte Geb."},{"key":"ref_180","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1126\/science.6836297","article-title":"Selective Photothermolysis: Precise Microsurgery by Selective Absorption of Pulsed Radiation","volume":"220","author":"Anderson","year":"1983","journal-title":"Science"},{"key":"ref_181","doi-asserted-by":"crossref","first-page":"223","DOI":"10.12788\/j.sder.2016.060","article-title":"A review of melasma treatment focusing on laser and light devices","volume":"35","author":"Li","year":"2016","journal-title":"Semin. Cutan. Med. Surg."},{"key":"ref_182","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ijwd.2017.01.004","article-title":"A review of laser and light therapy in melasma","volume":"3","author":"Trivedi","year":"2017","journal-title":"Int. J. Women\u2019s Dermatol."},{"key":"ref_183","first-page":"1196","article-title":"Intense Pulsed Light for the Treatment of Refractory Melasma in Asian Persons","volume":"30","author":"Wang","year":"2004","journal-title":"Dermatol. Surg."},{"key":"ref_184","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1007\/s00266-020-01637-x","article-title":"A Meta-analysis-Based Assessment of Intense Pulsed Light for Treatment of Melasma","volume":"44","author":"Yi","year":"2020","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_185","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1111\/j.1529-8019.2012.01530.x","article-title":"Single-session intense pulsed light combined with stable fixed-dose triple combination topical therapy for the treatment of refractory melasma","volume":"25","author":"Souza","year":"2012","journal-title":"Dermatol. Ther."},{"key":"ref_186","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1111\/j.1524-4725.2010.01849.x","article-title":"Sequential Treatment with Triple Combination Cream and Intense Pulsed Light is More Efficacious than Sequential Treatment with an Inactive (Control) Cream and Intense Pulsed Light in Patients with Moderate to Severe Melasma","volume":"37","author":"Goldman","year":"2011","journal-title":"Dermatol. Surg."},{"key":"ref_187","doi-asserted-by":"crossref","first-page":"13","DOI":"10.29271\/jcpsp.2018.01.13","article-title":"Efficacy of Intense Pulse Light Therapy And Tripple Combination Cream Versus Intense Pulse Light Therapy And Tripple Combination Cream Alone In Epidermal Melasma Treatment","volume":"28","author":"Shakeeb","year":"2018","journal-title":"J. Coll. Physicians Surg. Pak."},{"key":"ref_188","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1097\/DSS.0000000000000057","article-title":"Combination Treatment of Low-Fluence 1,064-nm Q-Switched Nd: YAG laser with novel intense pulse light in Korean melasma patients: A prospective, randomized, controlled trial","volume":"40","author":"Yun","year":"2014","journal-title":"Dermatol. Surg."},{"key":"ref_189","doi-asserted-by":"crossref","first-page":"373","DOI":"10.3109\/09546634.2015.1115812","article-title":"Topical tranexamic acid as an adjuvant treatment in melasma: Side-by-side comparison clinical study","volume":"27","author":"Chung","year":"2015","journal-title":"J. Dermatol. Treat."},{"key":"ref_190","first-page":"693","article-title":"Efficacy and Safety of Intense Pulsed Light in Treatment of Melasma in Chinese Patients","volume":"34","author":"Li","year":"2008","journal-title":"Dermatol. Surg."},{"key":"ref_191","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1111\/j.1524-4725.1994.tb00152.x","article-title":"Ineffective Treatment of Refractory Melasma and Postinflammatory Hyperpigmentation by Q-switched Ruby Laser","volume":"20","author":"Taylor","year":"1994","journal-title":"J. Dermatol. Surg. Oncol."},{"key":"ref_192","first-page":"59","article-title":"Combined Ultrapulse CO2 Laser and Q-Switched Alexandrite Laser Compared with Q-Switched Alexandrite Laser Alone for Refractory Melasma: Split-Face Design","volume":"29","author":"Angsuwarangsee","year":"2003","journal-title":"Dermatol. Surg."},{"key":"ref_193","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1111\/j.1524-4725.1994.tb03707.x","article-title":"The Removal of Cutaneous Pigmented Lesions with the Q-switched Ruby Laser and the Q-switched Neodymium: Yttrium-Aluminum-Garnet Laser. A comparative study","volume":"20","author":"Tse","year":"1994","journal-title":"J. Dermatol. Surg. Oncol."},{"key":"ref_194","doi-asserted-by":"crossref","first-page":"10","DOI":"10.4103\/ijdvl.IJDVL_1086_16","article-title":"Optimizing Q-switched lasers for melasma and acquired dermal melanoses","volume":"85","author":"Aurangabadkar","year":"2019","journal-title":"Indian J. Dermatol. Venereol. Leprol."},{"key":"ref_195","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/j.1365-2230.2012.04473.x","article-title":"Histopathological study of the treatment of melasma lesions using a low-fluence Q-switched 1064-nm neodymium:yttrium-aluminium-garnet laser","volume":"38","author":"Kim","year":"2013","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_196","doi-asserted-by":"crossref","first-page":"2333","DOI":"10.1038\/jid.2010.129","article-title":"Subcellular Selective Photothermolysis of Melanosomes in Adult Zebrafish Skin Following 1064-nm Q-Switched Nd:YAG Laser Irradiation","volume":"130","author":"Kim","year":"2010","journal-title":"J. Investig. Dermatol."},{"key":"ref_197","doi-asserted-by":"crossref","first-page":"76","DOI":"10.4103\/JCAS.JCAS_179_18","article-title":"Laser toning in melasma","volume":"12","author":"Shah","year":"2019","journal-title":"J. Cutan. Aesthetic Surg."},{"key":"ref_198","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1097\/DSS.0000000000001120","article-title":"The Clinical and Histological Effect of a Low-Fluence Q-Switched 1,064-nm Neodymium:Yttrium-Aluminum-Garnet Laser for the Treatment of Melasma and Solar Lentigenes in Asians: Prospective, Randomized, and Split-Face Comparative Study","volume":"43","author":"Kaminaka","year":"2017","journal-title":"Dermatol. Surg."},{"key":"ref_199","doi-asserted-by":"crossref","unstructured":"Elkamshoushi, A.M., Romisy, D., and Omar, S.S. (2022). Oral tranexamic acid, hydroquinone 4% and low-fluence 1064 nm Q-switched Nd:YAG laser for mixed melasma: Clinical and dermoscopic evaluation. J. Cosmet. Dermatol.","DOI":"10.1111\/jocd.14140"},{"key":"ref_200","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/j.1524-4725.2009.01383.x","article-title":"Low-Fluence Q-Switched Neodymium-Doped Yttrium Aluminum Garnet (1,064 nm) Laser for the Treatment of Facial Melasma in Asians","volume":"36","author":"Wattanakrai","year":"2010","journal-title":"Dermatol. Surg."},{"key":"ref_201","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1111\/j.1524-4725.2010.01523.x","article-title":"Low-Fluence Q-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser for Melasma with Pre- or Post-Treatment Triple Combination Cream","volume":"36","author":"Jeong","year":"2010","journal-title":"Dermatol. Surg."},{"key":"ref_202","doi-asserted-by":"crossref","first-page":"266","DOI":"10.4103\/0974-2077.104915","article-title":"A comparison of low-fluence 1064-nm Q-switched Nd: YAG laser with topical 20% azelaic acid cream and their combination in melasma in Indian patients","volume":"5","author":"Bansal","year":"2012","journal-title":"J. Cutan. Aesthetic Surg."},{"key":"ref_203","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1111\/jocd.12444","article-title":"Q-switched Nd: YAG laser alone or with modified Jessner chemical peeling for treatment of mixed melasma in dark skin types: A comparative clinical, histopathological, and immunohistochemical study","volume":"17","author":"Saleh","year":"2018","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_204","doi-asserted-by":"crossref","first-page":"523","DOI":"10.3109\/09546634.2013.848261","article-title":"A comparative study of low-fluence 1064-nm Q-switched Nd:YAG laser with or without chemical peeling using Jessner\u2019s solution in melasma patients","volume":"25","author":"Lee","year":"2014","journal-title":"J. Dermatol. Treat."},{"key":"ref_205","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1111\/j.1365-2230.2011.04150.x","article-title":"A randomized, observer-blinded, comparison of combined 1064-nm Q-switched neodymium-doped yttrium-aluminium-garnet laser plus 30% glycolic acid peel vs. laser monotherapy to treat melasma","volume":"36","author":"Park","year":"2011","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_206","doi-asserted-by":"crossref","first-page":"165","DOI":"10.4103\/0378-6323.93633","article-title":"A comparative study on efficacy of high and low fluence Q-switched Nd:YAG laser and glycolic acid peel in melasma","volume":"78","author":"Kar","year":"2012","journal-title":"Indian J. Dermatol. Venereol. Leprol."},{"key":"ref_207","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1080\/09546634.2019.1708847","article-title":"A comparative study between oral tranexamic acid versus oral tranexamic acid and Q-switched Nd-YAG laser in melasma treatment: A clinical and dermoscopic evaluation","volume":"32","author":"Agamia","year":"2020","journal-title":"J. Dermatol. Treat."},{"key":"ref_208","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1007\/s10103-021-03483-y","article-title":"Split-face comparative study between intradermal tranexamic acid injection alone versus intradermal tranexamic acid injection combined with Q-switched Nd:YAG laser in melasma treatment: Dermoscopic and clinical evaluation","volume":"37","author":"Hawwam","year":"2022","journal-title":"Lasers Med. Sci."},{"key":"ref_209","doi-asserted-by":"crossref","first-page":"e15287","DOI":"10.1111\/dth.15287","article-title":"Evaluating the tolerance and efficacy of laser-assisted delivery of tranexamic acid, niacinamide, and kojic acid for melasma: A single center, prospective, split-face trial","volume":"35","author":"Park","year":"2022","journal-title":"Dermatol. Ther."},{"key":"ref_210","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1111\/dsu.12060","article-title":"Oral Tranexamic Acid Enhances the Efficacy of Low-Fluence 1064-Nm Quality-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser Treatment for Melasma in Koreans: A Randomized, Prospective Trial","volume":"39","author":"Shin","year":"2013","journal-title":"Dermatol. Surg."},{"key":"ref_211","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1080\/14764172.2017.1342036","article-title":"A split-face, investigator-blinded comparative study on the efficacy and safety of Q-switched Nd:YAG laser plus microneedling with vitamin C versus Q-switched Nd:YAG laser for the treatment of recalcitrant melasma","volume":"19","author":"Ustuner","year":"2017","journal-title":"J. Cosmet. Laser Ther."},{"key":"ref_212","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1080\/09546634.2018.1516858","article-title":"Combined treatment of melasma involving low-fluence Q-switched Nd:YAG laser and fractional microneedling radiofrequency","volume":"30","author":"Kwon","year":"2019","journal-title":"J. Dermatol. Treat."},{"key":"ref_213","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1002\/lsm.21156","article-title":"Successful treatment of melasma using a combination of microdermabrasion and Q-switched Nd:YAG lasers","volume":"44","author":"Kauvar","year":"2012","journal-title":"Lasers Surg. Med."},{"key":"ref_214","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5021\/ad.2018.30.1.1","article-title":"Treatment of Melasma with Pulsed-Dye Laser and 1,064-nm Q-Switched Nd:YAG Laser: A Split-Face Study","volume":"30","author":"Kong","year":"2018","journal-title":"Ann. Dermatol."},{"key":"ref_215","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1111\/dth.12250","article-title":"New insight in the treatment of refractory melasma: Laser Q-switched Nd: YAG non-ablative fractionated followed by intense pulsed light","volume":"28","author":"Cunha","year":"2015","journal-title":"Dermatol. Ther."},{"key":"ref_216","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1111\/jdv.12854","article-title":"Low-fluence Q-switched Nd: YAG 1064-nm laser and intense pulsed light for the treatment of melasma","volume":"29","author":"Vachiramon","year":"2015","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_217","doi-asserted-by":"crossref","first-page":"2099","DOI":"10.1007\/s10103-022-03514-2","article-title":"Laser therapy in the treatment of melasma: A systematic review and meta-analysis","volume":"37","author":"Lai","year":"2022","journal-title":"Lasers Med. Sci."},{"key":"ref_218","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1097\/DSS.0000000000000653","article-title":"Clinical and Histopathologic Assessment of Facial Melasma After Low-Fluence Q-Switched Neodymium-Doped Yttrium Aluminium Garnet Laser","volume":"42","author":"Parra","year":"2016","journal-title":"Dermatol. Surg."},{"key":"ref_219","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1111\/j.1524-4725.2011.02001.x","article-title":"Efficacy and Safety of Q-Switched 1,064-nm Neodymium-Doped Yttrium Aluminum Garnet Laser Treatment of Melasma","volume":"37","author":"Xi","year":"2011","journal-title":"Dermatol. Surg."},{"key":"ref_220","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1111\/jocd.12253","article-title":"Long-term results in low-fluence 1064-nm Q-Switched Nd:YAG laser for melasma: Is it effective?","volume":"15","author":"Gokalp","year":"2016","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_221","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1002\/lsm.20048","article-title":"Fractional Photothermolysis: A New Concept for Cutaneous Remodeling Using Microscopic Patterns of Thermal Injury","volume":"34","author":"Manstein","year":"2004","journal-title":"Lasers Surg. Med."},{"key":"ref_222","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1002\/lsm.20937","article-title":"Non-ablative 1,550 nm fractional laser therapy versus triple topical therapy for the treatment of melasma: A randomized controlled split-face study","volume":"42","author":"Wind","year":"2010","journal-title":"Lasers Surg. Med."},{"key":"ref_223","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/j.jaad.2010.01.048","article-title":"Nonablative 1550-nm fractional laser therapy versus triple topical therapy for the treatment of melasma: A randomized controlled pilot study","volume":"64","author":"Kroon","year":"2011","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_224","doi-asserted-by":"crossref","first-page":"218","DOI":"10.3109\/09546634.2012.671911","article-title":"Combination of fractional erbium-glass laser and topical therapy in melasma resistant to triple-combination cream","volume":"25","author":"Tourlaki","year":"2014","journal-title":"J. Dermatol. Treat."},{"key":"ref_225","doi-asserted-by":"crossref","first-page":"10","DOI":"10.25289\/ML.2017.6.1.10","article-title":"Treatment of Melasma Using a Novel 1,927 nm Fractional Thulium Laser: A Retrospective Analysis of 68 Korean Patients","volume":"6","author":"Rho","year":"2017","journal-title":"Med Lasers"},{"key":"ref_226","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1002\/lsm.22100","article-title":"Treatment of melasma with the 1,927-nm fractional thulium fiber laser: A retrospective analysis of 20 cases with long-term follow-up","volume":"45","author":"Massaki","year":"2013","journal-title":"Lasers Surg. Med."},{"key":"ref_227","first-page":"585","article-title":"Lasers in Melasma: A Review with Consensus Recommendations by Indian Pigmentary Expert Group","volume":"62","author":"Sarkar","year":"2017","journal-title":"Indian J. Dermatol."},{"key":"ref_228","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1002\/lsm.22735","article-title":"Efficacy and safety of a novel picosecond laser using combination of 1 064 and 595 nm on patients with melasma: A prospective, randomized, multicenter, split-face, 2% hydroquinone cream-controlled clinical trial","volume":"49","author":"Choi","year":"2017","journal-title":"Lasers Surg. Med."},{"key":"ref_229","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1089\/photob.2019.4644","article-title":"Efficacy and Safety Evaluation of Picosecond Alexandrite Laser with a Diffractive Lens Array for Treatment of Melasma in Asian Patients by VISIA Imaging System","volume":"37","author":"Chen","year":"2019","journal-title":"Photobiomodulation Photomed. Laser Surg."},{"key":"ref_230","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1080\/14764172.2017.1376098","article-title":"Effects of a fractional picosecond 1,064 nm laser for the treatment of dermal and mixed type melasma","volume":"20","author":"Chalermchai","year":"2018","journal-title":"J. Cosmet. Laser Ther."},{"key":"ref_231","doi-asserted-by":"crossref","first-page":"522","DOI":"10.5021\/ad.2021.33.6.522","article-title":"A Clinical and Biochemical Evaluation of a Temperature-Controlled Continuous Non-Invasive Radiofrequency Device for the Treatment of Melasma","volume":"33","author":"Kwon","year":"2021","journal-title":"Ann. Dermatol."},{"key":"ref_232","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1097\/DSS.0000000000003367","article-title":"Therapeutic Effects of New Pulsed-Type Microneedling Radiofrequency for Refractory Facial Pigmentary Disorders","volume":"48","author":"Park","year":"2022","journal-title":"Dermatol. Surg."},{"key":"ref_233","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.fsc.2019.09.013","article-title":"Microneedle Radiofrequency","volume":"28","author":"Alexiades","year":"2020","journal-title":"Facial Plast. Surg. Clin. North Am."},{"key":"ref_234","unstructured":"Cameli, N., Abril, E.E., Mariano, M., and Berardesca, E. (2014). Combined use of monopolar radiofrequency and transdermal drug delivery in the treatment of melasma. Dermatol. Surg., 40."},{"key":"ref_235","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1111\/jocd.14644","article-title":"Safety and efficacy of mesotherapy in the treatment of melasma: A review article","volume":"21","author":"Khalili","year":"2022","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_236","first-page":"502","article-title":"Comparing the Efficacy of Patelet-rich Plasma (PRP) versus Tranexamic Acid (4mg\/mL) as Intradermal Treatments of Melasma","volume":"30","author":"Mumtaz","year":"2021","journal-title":"J. Coll. Physicians Surg. Pak."},{"key":"ref_237","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1097\/DSS.0000000000003266","article-title":"Platelet-Rich Plasma in Melasma\u2014A Systematic Review","volume":"48","author":"Sarkar","year":"2022","journal-title":"Dermatol. Surg."},{"key":"ref_238","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1007\/s13555-021-00575-z","article-title":"Efficacy and Safety of Platelet-Rich Plasma in Melasma: A Systematic Review and Meta-Analysis","volume":"11","author":"Zhao","year":"2021","journal-title":"Dermatol. Ther."},{"key":"ref_239","doi-asserted-by":"crossref","first-page":"2431","DOI":"10.1111\/jocd.14229","article-title":"Platelet-rich plasma is a promising therapy for melasma","volume":"20","author":"Tuknayat","year":"2021","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_240","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.jaad.2021.03.116","article-title":"Microneedling as an adjuvant to topical therapies for melasma: A systematic review and meta-analysis","volume":"86","author":"Bailey","year":"2022","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_241","doi-asserted-by":"crossref","first-page":"1857","DOI":"10.1111\/jocd.14836","article-title":"Systematic review of clinical studies assessing the needling for treatment of melasma: Focusing on efficacy, safety, and recurrence rate","volume":"21","author":"Behrangi","year":"2022","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_242","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1097\/DSS.0000000000002763","article-title":"A Systematic Review of the Efficacy and Safety of Microneedling in the Treatment of Melasma","volume":"46","author":"Wu","year":"2020","journal-title":"Dermatol. Surg."},{"key":"ref_243","doi-asserted-by":"crossref","unstructured":"Morgado-Carrasco, D., Piquero-Casals, J., Granger, C., Trull\u00e0s, C., and Passeron, T. (2022). Melasma: The need for tailored photoprotection to improve clinical outcomes. Photodermatol. Photoimmunol. Photomed.","DOI":"10.1111\/phpp.12783"},{"key":"ref_244","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1038\/jid.2011.476","article-title":"Irradiation of Skin with Visible Light Induces Reactive Oxygen Species and Matrix-Degrading Enzymes","volume":"132","author":"Liebel","year":"2012","journal-title":"J. Investig. Dermatol."},{"key":"ref_245","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1038\/jid.2010.95","article-title":"Impact of Long-Wavelength UVA and Visible Light on Melanocompetent Skin","volume":"130","author":"Mahmoud","year":"2010","journal-title":"J. Investig. Dermatol."},{"key":"ref_246","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.det.2018.12.008","article-title":"What\u2019s New in Pigmentary Disorders","volume":"37","author":"Zubair","year":"2019","journal-title":"Dermatol. Clin."},{"key":"ref_247","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/phpp.12086","article-title":"Near-visible light and UV photoprotection in the treatment of melasma: A double-blind randomized trial","volume":"30","year":"2014","journal-title":"Photodermatol. Photoimmunol. Photomed."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/19\/12084\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:38:51Z","timestamp":1760143131000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/19\/12084"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,24]]},"references-count":247,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["ijerph191912084"],"URL":"https:\/\/doi.org\/10.3390\/ijerph191912084","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,24]]}}}