Mechanisms, efficacy, and safety of active ingredients for melasma treatment: A mini-review

Melasma is a common and chronic skin disorder, typically marked by the appearance of brown or gray-brown irregular patches on sun-exposed areas of the body, most frequently on the face, cheeks, forehead, and upper lip, with significant and sometimes severe effects on quality of life due to its high visibility, cosmetic concerns, and associated psychological burden. Its formation is strongly linked to a combination of genetic predisposition, hormonal changes related to pregnancy or contraceptive use, prolonged ultraviolet exposure, and persistent low-grade inflammation within the skin. Managing melasma remains a challenging and often frustrating task for both patients and clinicians, yet topical active extracts continue to offer encouraging and promising results. Agents such as hydroquinone, retinoids, vitamin C, niacinamide, and natural bioactive compounds derived from licorice root or green tea extract act through multiple complementary mechanisms to inhibit melanin synthesis, block tyrosinase activity, regulate oxidative stress, and reduce abnormal melanin distribution. Moreover, advanced and innovative drug delivery technologies, including liposomes, solid lipid carriers, and polymer-based nanoparticles, significantly enhance skin penetration, stability, and overall therapeutic efficacy. This review outlines in detail the underlying mechanisms of melasma, carefully assesses the efficacy and safety of topical active extracts, and highlights their growing clinical relevance. By synthesizing current research findings, this manuscript ultimately aims to guide healthcare professionals in selecting the most appropriate topical treatments, thereby contributing to improved clinical management strategies and better long-term outcomes for patients suffering from melasma.