Oral Therapies for Melasma

The presentation focuses on the evolving realm of oral therapies for melasma, a complex dermatological condition often misconceived solely as a cosmetic issue. The speaker emphasizes melasma as a medical condition rooted in multiple inflammatory factors and psychological impacts. With growing interest in this area during a prominent dermatology meeting, the speaker discusses various oral treatments, including oral polypodium leukotomos, which serves as an adjunct to sunscreen by providing a UV protective benefit. Methimazole, a thyroid medication, shows promise in treating melasma due to its effects on melanocyte enzymes, while oral glutathione remains controversial due to concerns about bioavailability and efficacy compared to its intravenous counterpart. Oral tranexamic acid is highlighted for its anti-inflammatory properties and success in reducing melasma symptoms, with suggested dosages varying by region. Additionally, oral metformin is being studied for its potential benefits, and antihistamines, particularly H2 blockers, are introduced as adjunct treatments that may prevent melasma exacerbation by inhibiting mast cell degranulation. Overall, the speaker advocates for a polytherapeutic approach to melasma, integrating insights from contemporary research and expert findings.