Il trattamento medico-domiciliare del melasma con agenti schiarenti

Melasma is an hyperpigmentation of the skin of unknown origin exacerbated by different stimuli as UV light, hormones and cosmetics. Genetic predisposition has been postulated. It is the consequence of an increased amount of melanin either within the epidermis, the dermis or both. Avoidance of direct exposure to sunlight and the regular use of broad spectrum sunscreens is a pre-requisite before starting therapy. Topical hypo/depigmenting agents are most effective when the increased of melanin content is within the epidermis. Two nwjor groups of hypo/ depigmenting agents have been used: phenolic derivatives and non phenolic compounds. Hydroquinone among phenolic derivatives has been used most extensively. It is applied either alone or in combination with tretinoin and corticosteroid. Due to its side effects hydroquinone, at least in Italy, is out of the market. Rucinol is an emerging compound in the treatment of melasma patients without side effects and proved efficacy. Nonphenolic depigmenting agents include azelaic acid, kojic acid, adapalene, liquotice extracts and many others. One single principle, picnogenol, has demonstrated to be effective in melasma after oral supplementation.