Study explores potential of oral melatonin in treating stubborn melasma

The study suggests considering oral melatonin as a well-tolerated off-label treatment for patients with recalcitrant melasma, although additional research is required.

Melasma, referred to as the "mask of pregnancy," typically manifests as dark patches on the face, particularly on the cheeks, forehead, and upper lip. While various topical treatments and procedures exist, recalcitrant cases—those resistant to conventional therapies—present a significant clinical dilemma for dermatologists and patients alike.

The study conducted by Rashmi Sarkar, Lady Hardinge Medical College and Maulana Azad Medical College, New Delhi, India, and colleagues aimed to evaluate the efficacy of oral melatonin supplementation in reducing the severity of melasma and improving patients' quality of life.

Melatonin, a hormone primarily known for its role in regulating sleep-wake cycles, has garnered increasing attention for its potential antioxidant and anti-inflammatory properties. Researchers hypothesized that oral melatonin supplementation could modulate melanogenesis, the process by which melanin is produced in the skin, thereby mitigating hyperpigmentation associated with melasma.

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

Following 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 from baseline in the Melasma Area and Severity Index scores.

The findings underscore the potential of oral melatonin as a safe and effective adjunctive therapy for individuals struggling with stubborn melasma. By harnessing melatonin's antioxidant and anti-inflammatory properties, dermatologists may have a valuable tool in their arsenal for addressing this challenging condition.

While further research is needed to elucidate the optimal dosage, duration, and long-term effects of oral melatonin supplementation in melasma management, the study represents a significant step forward in expanding treatment options for patients with recalcitrant cases.

In conclusion, the investigation into the use of oral melatonin in recalcitrant melasma offers renewed hope for individuals seeking relief from this distressing skin condition. As dermatologists continue to explore innovative therapeutic approaches, oral melatonin stands out as a promising avenue for improving outcomes and enhancing the quality of life for those affected by melasma.

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