Breakthrough Study Reveals Effectiveness of Oral Melatonin in Treating Stubborn Melasma

The study suggests that clinicians could consider oral melatonin as a well-tolerated off-label treatment for patients with recalcitrant melasma, although there is a need for additional research.

Melatonin, known for its role in regulating sleep patterns, exhibits potent antioxidant properties. This led Rashmi Sarkar, Lady Hardinge Medical College, Maulana Azad Medical College, New Delhi, India, and colleagues to seek to determine if melatonin could potentially mitigate the hyperpigmentation associated with melasma. They aimed to explore alternative therapies for patients resistant to conventional treatments.

The authors present data from 7 patients with recalcitrant melasma treated with oral melatonin. All patients previously received treatment with either topical creams, including chemical peels, topical combination cream, or oral tranexamic acid, without significant improvements.

The study led to the following findings:

• After a 4-week washout period, all patients received daily 3-mg melatonin tablets and used sunscreen for 12 weeks.
• All patients reported lightening of pigmentation, and there was an improvement in the Melasma Area and Severity Index scores from baseline.

"The effectiveness of oral melatonin in treating recalcitrant melasma is a game-changer for patients and dermatologists. Not only does it offer a promising alternative for those who have exhausted traditional treatment options, but it also sheds light on the role of antioxidants in managing hyperpigmentation," the researchers wrote.

"Melasma disproportionately affects individuals with darker skin tones, making effective treatment options crucial. The advent of oral melatonin provides renewed hope for patients who have long struggled with this challenging condition."

While further research is warranted to elucidate the mechanisms underlying melatonin's efficacy and to determine optimal dosage regimens, the study represents a significant step forward in managing recalcitrant melasma. As dermatologists continue exploring innovative skincare approaches, oral melatonin emerges as a promising addition to the armamentarium against this prevalent and often distressing condition.

Reference:

Sarkar, R., Verma, B., & Mendiratta, V. Use of oral melatonin in recalcitrant melasma. International Journal of Dermatology. https://doi.org/10.1111/ijd.17201