摘要

Objectives: To review the scientific rationale, mechanisms of action, and clinical evidence supporting the use of oral supplements as adjuncts in the management of melasma and hyperpigmentation. Introduction: Melasma and post-inflammatory hyperpigmentation are chronic pigmentary disorders with high recurrence rates and significant psychosocial impact. Although topical therapies and procedures remain central to management, interest in systemic adjunctive strategies has increased, particularly those with favorable long-term safety profiles. Materials / method: This presentation reviews key mechanistic studies, randomized controlled trials, prospective clinical studies, and real-world clinical experience involving oral supplements with documented relevance in pigmentary disorders, including Pinus pinaster (French maritime pine bark extract), Polypodium leucotomos, carotenoids, and selected supportive agents. Methods Available evidence was analyzed with emphasis on clinical outcomes, mechanistic plausibility, safety, and positioning of oral agents as adjuncts to standard therapies, including topical treatments, photoprotection, and procedures. Results: Oral supplements may support pigmentation management through multiple pathways, including modulation of melanogenesis, reduction of inflammation and cytokine signaling, enhancement of systemic photoprotection, and improvement of dermal structure. Among evaluated agents, Pinus pinaster and Polypodium leucotomos demonstrate the most consistent clinical and mechanistic evidence as adjuncts in melasma. Conclusion: Oral supplements represent effective and well-tolerated adjuncts in the multimodal management of melasma and hyperpigmentation. Their optimal use lies in complementing, rather than replacing, established topical therapies and photoprotective strategies.