Objectives: - Up to the date of new insights in melasma pathogeny,
- Strategy of treatment based on a holistic and integrative approach,
- Tips and tricks for laser treatment.

Introduction: Melasma is a commonly acquired hyper melanosis characterized by symmetric, reticulated hyperpigmentations of sun-exposed areas of the skin, particularly the face. Melasma has a higher prevalence in women and patients of darker skin tones, although it can occur in all skin types.

The dyspigmentation caused by melasma often has a negative psychosocial impact on those affected with the condition, as demonstrated by patient-reported anhedonia, decreased self-esteem, dissatisfactory mood, and impairment in social and occupational functioning.

Materials / method: The pathogenesis of melasma is still unclear; however, various factors have been implicated and well supported, such as ultraviolet radiation exposure, genetic predisposition, and hormonal influences.

Features of the involved skin include solar elastosis and increased mast cells, dermal blood vessels, altered basal membrane, abnormal barrier function, and vascular endothelial growth factor expression.

The latest evidence on the pathophysiology of melasma suggests that melasma might be a photoaging skin disorder affecting genetically predisposed individuals.

Results: Due to the incomplete understanding of its pathogenesis and the high recurrence rate, melasma remains a complex disorder to manage, resulting in physician frustration and patient dissatisfaction.




Several topical, oral, and procedural treatment options are available, with varying mechanisms of action addressing the multifactorial nature of the disorder. The treatment of melasma remains highly challenging, with inconsistent results and almost constant relapses.

Conclusion: A multimodality approach addressing the multifactorial nature of the disorder is optimal.

Daily photoprotection (with broad-spectrum sunscreens that combine UVA and UVB filters with visible light blockers), topical therapies, chemical peelings, systemic products, and procedures (chemical peels, micro-needling, and lasers) could be used in various combinations to treat melasma.

Several new therapies are emerging as promising agents to treat melasma, but further clinical studies are warranted to investigate their efficacy.

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Objectives: To update topical depigmentation concepts for treating melasma effectively and on the longterm

Introduction: Treating hyperpigmentation disorders such as melasma successfully especially on the long term is a major challenge in aesthetic dermatology. Once decided for a topical strategy for depigmentation, a distinct understanding of the pathogenesis of melasma and the signaling routs of melanogenesis is required. This better understanding and recent newly found compounds open up new therapeutic approaches.

Materials / method: Melanogenesis is a highly regulated process in which the natural skin protecting pigment melanin plays a major role. This molecule is synthesized from the melanocytes of the epidermis upon well-known triggers such as UV exposure, cosmeceuticals but also oxidative stress and other triggers not to well known yet. The complex process results in hyperactive melanocytes overproducing melanin and its accumulation resulting in unwanted hyperpigmentation and dermatological diseases such as Melasma.
Complex scientific data shows that there are several signaling pathways by which different cell types up

Conclusion: A profound understanding on how to intervene effectively in the complex process of melisma formation opens up new treatment possibilities to effectively control melisma, especially on the long term. Combining different topicals is an effective and safe tool to treat this psychologically extremely stressful skin disease.

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Objectives: The aim of our experience has been to improve benign hyperpigmentations with particular interest to melasma

Introduction: Melasma is an acquired skin pigmentation disorder, most commonly seen in darker skin. The management of melasma is challenging and requires multiple uses of available therapeutic options.

Materials / method: We report our experience with a new 675 nm non ablative fractional laser in the treatment of melasma, especially in skin colour patients. Different effective and safe parameters and features including power, dwell time, stack mode, fractional emission and sapphire tip have been investigated and applied

Results: All pigmented benign lesions treated with 675 nm laser have been totally enlightened. Recurrency has been noted in one case out of 25 melasma patients

Conclusion: The high affinity with melanin, combined with a minimum but specific interaction with the vascular component and with water, and the greater degree of penetration with a reduction in bulk tissue heating, make this system very promising in the treatment of pigmentary disorders, reducing the risk of side. Cooling is particularly important in skin of color as it protects the epidermis and reduces the risk of erythema and edema, which may lead to subsequent post-inflammatory hyperpigmentation and recurrent melasma.

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