MELASMA: UNDERSTANDING ITS COMPLEXITY AND ACCURATE THERAPEUTIC APPROACHES

Introduction: Melasma is an acquired pigmentary condition, primarily affecting the face, and predominantly occurs in women with darker skin phototypes. Objective: This literature review aims to explore the etiology, epidemiological characteristics, pathophysiology, pathogenesis, and treatments of melasma, with the purpose of deepening the understanding of this skin disorder and enhancing therapeutic approaches. Methodology: The study involves an analysis of relevant research on the topic, highlighting the influence of ultraviolet radiation, hormones, and genetic predisposition as the main etiological factors. Theoretical Framework: The review delves into the complex interaction between melanocytes, keratinocytes, and other cellular components in the pathogenesis of melasma. Estrogen plays a significant role, especially due to its increase in pregnant women, post-pubertal women, and users of oral contraceptives. Results and Discussion: Data reveal the high prevalence of melasma in women aged 20 to 40 years, particularly in Fitzpatrick skin types III to VI, with a predominance of the centrofacial and malar patterns. Additionally, treatments emphasize the use of chemical peels, hydroquinone, and retinoic acid, with a focus on combination therapies for greater efficacy. Conclusion: The need for personalized therapeutic strategies is emphasized, given the complexity of melasma and the diversity of factors influencing its development and persistence, underscoring the importance of ongoing studies to improve the clinical management of this condition.