Comprehensive Evaluation of Pathogenesis, Risk Factors and Current Therapeutic Strategies in Melasma: A Clinical and Molecular Perspective

Abstract

Melasma, an acquired facial hyperpigmentation of a chronic nature, presents a clinical and dermatologic enigma of considerable relevance. This article focuses on a comprehensive review of the underlying pathogenesis of melasma from a molecular and clinical perspective, exploring its multifactorial etiology and the triggering elements that converge in the cascade of biochemical and cellular events that result in its distinctive clinical manifestation. Known risk factors such as excessive sun exposure, hormonal imbalances and genetic predisposition are thoroughly discussed, unraveling their relative contribution and complex interplay in the development of melasma. In addition, a critical analysis is made of current therapeutic strategies, ranging from conventional topical approaches to more advanced modalities such as laser therapy and technology-based treatments. The efficacy, safety and limitations of these modalities are examined, considering variations in patient response and the durability of the results obtained. Ultimately, this article seeks to provide a comprehensive synthesis of contemporary advances in the understanding and management of melasma, with the aspiration of guiding dermatologic health care professionals toward more accurate and individualized approaches in the diagnosis and treatment of this complex skin condition.