title: Melasma: systematic review of the systemic treatments.
abstract: Currently available treatment options for melasma include prevention of UV radiation, topical lightening agents, chemical peels, and light-based and laser therapies. However, none have shown effective and sustained results, with incomplete clearance and frequent recurrences. There has been increasing interest recently in oral medications and dietary supplements in improving melasma. We sought to evaluate the efficacy and safety/tolerability of oral medications and dietary supplements for the treatment of melasma. Multiple databases were systematically searched for randomized clinical trials (RCTs) evaluating the use of oral medication for treatment of melasma alone or in combination with other treatments. A total of eight RCTs met inclusion criteria. Oral medications and dietary supplements evaluated include tranexamic acid, Polypodium leucotomos extract, beta-carotenoid, melatonin, and procyanidin. These agents appear to have a beneficial effect on melasma improvement. In conclusion, oral medications have a role in melasma treatment and have been shown to be efficacious and tolerable with a minimal number and severity of adverse events. Therefore, dermatologists should keep oral medications and dietary supplements in their armamentarium for the treatment of melasma.
authors.affiliation: Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Linghong Linda
authors.initials: LL
authors.lastname: Zhou
authors.affiliation: Division of Dermatology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Akerke
authors.initials: A
authors.lastname: Baibergenova
mesh_terms: D000284:Administration, Oral; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000975:Antioxidants / Q000627:therapeutic use; D044946:Biflavonoids / Q000627:therapeutic use; D002338:Carotenoids / Q000627:therapeutic use; D002392:Catechin / Q000627:therapeutic use; D019587:Dietary Supplements; D006801:Humans; D008548:Melanosis / Q000188:drug therapy*; D008550:Melatonin / Q000627:therapeutic use; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use; D032494:Polypodium; D044945:Proanthocyanidins / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D014148:Tranexamic Acid / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000933:Antifibrinolytic Agents; D000975:Antioxidants; D044946:Biflavonoids; D010936:Plant Extracts; D044945:Proanthocyanidins; D002338:Carotenoids; C017674:procyanidin; D014148:Tranexamic Acid; D002392:Catechin; D008550:Melatonin