Overview
Melasma, formerly known as chloasma, is an acquired pigmentary condition, occurring most commonly on the face. This disorder, which is more prevalent in females and darker skin types, is predominantly attributed to ultraviolet (UV) exposure and hormonal influences. Melasma is generally a clinical diagnosis consisting of symmetric reticulated hypermelanosis in three predominant facial patterns: centrofacial, malar, and mandibular . The major clinical pattern in 50–80% of cases is the centrofacial pattern, which affects the forehead, nose, and upper lip, excluding the philtrum, cheeks, and chin . The malar pattern is restricted to the malar cheeks on the face, while mandibular melasma is present on the jawline and chin. The latter is thought to occur in older individuals and may be more related to severe photodamage . A newer pattern termed extra-facial melasma can occur on non-facial body parts, including the neck, sternum, forearms, and upper extremities . Though common, the management of this disorder remains challenging given the incomplete understanding of the pathogenesis, its chronicity, and recurrence rates. In addition to traditional treatments for melasma, there are also promising new treatments, including topical, oral, and procedural therapies. This review will provide an up-to-date overview of the current literature on melasma, including clinical diagnosis, pathogenesis, and treatments including discussion of new topical, oral, and procedural therapies. This article is based on previously conducted studies and does not involve new studies of human or animal subjects performed by the authors.