Current concepts in melasma - A review article

Melasma is a common acquired hypermelanosis of the face, the treatment of which is challenging. The pathogenesis of melasma is complex and multifactorial. The classical triggering factors of melasma include positive family history, exposure to ultraviolet radiation, and hormonal factors. Apart from this, newer theories implicated in the pathogenesis of melasma include neural and vascular factors, impairment of barrier function, function of visible light, and other molecular pathways. Recent studies have also suggested the importance of cells other than the melanocytes such as keratinocytes, fibroblast, mast cells, and cutaneous vasculature in the pathogenesis of melasma. Identification of these factors will help in targeted treatment, which may have longer remission and reduced relapse rates.