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This narrative review synthesizes current understanding of melasma pathophysiology, evaluates innovations in topical and procedural therapies, and analyzes limitations that contribute to high recurrence. Findings emphasize dysregulated melanogenesis, pigment incontinence, and evolving multi-target combination and regenerative directions.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/targeting-melasma-innovations-in-pigment-deposition-and-photoaging-in-cosmetic-dermatology/460805/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/targeting-melasma-innovations-in-pigment-deposition-and-photoaging-in-cosmetic-dermatology/460805.png","ImageObject",300,407,{"name":92,"@type":93},"\tJames","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-11","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What factors drive melasma development and recurrence?","Question",{"text":113,"@type":114},"Melasma is driven by interactions among genetic predisposition, hormonal fluctuations, UV exposure, oxidative stress, inflammation, and photoaging, leading to dysregulated melanogenesis and high relapse risk.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What innovations are highlighted for melasma treatment?",{"text":118,"@type":114},"The review highlights newer topical brighteners and antioxidants, tranexamic acid, improved topical delivery systems, and procedural options such as low-fluence picosecond lasers and fractional CO2 laser–assisted drug delivery.",{"name":120,"@type":111,"acceptedAnswer":121},"Why is achieving durable treatment control still difficult?",{"text":122,"@type":114},"Durability is limited by relapse, heterogeneous subtypes, risks such as post-inflammatory hyperpigmentation, and inconsistent adherence to treatment regimens.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},460805,1791333058,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},2336474466412,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Journal of Cosmetic Dermatology  \nTargeting Melasma: Innovations in Pigment Deposition and Photoaging in Cosmetic Dermatology  \nTing Liao1  | Rui Luo2  | Ying Deng1  | Hongqiu Yang1  | Yu Du1   \n1Medical Cosmetic Center, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, People's Republic of China | 2Department of Acupuncture and Rehabilitation, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, People's Republic of China  \nCorrespondence: Yu Du ([duyu@swmu.edu.cn](duyu@swmu.edu.cn))  \nReceived: 5 September 2025 | Revised: 10 December 2025 | Accepted: 26 December 2025  \nKeywords: hormonal influences | laser therapy | melasma | photoaging | pigmentation | topical treatments | UV exposure  \nABSTRACT  \nBackground: Melasma is a chronic, relapsing hyperpigmentation disorder driven by complex interactions among genetic predisposition, hormonal fluctuations, UV exposure, oxidative stress, inflammation, and photoaging. Its psychosocial impact is substantial, especially among women with darker skin types, and treatment remains challenging due to its multifactorial pathogenesis and high recurrence rates.  \nAims: This review aims to synthesize current knowledge on melasma pathophysiology, highlight recent innovations in topical and procedural therapies, identify limitations of existing treatments, and outline future directions toward personalized and regenerative approaches.  \nPatients/Methods: A narrative literature review was performed, summarizing findings from epidemiologic studies, molecular investigations, and clinical trials. Key topics included pigment biology, hormonal and environmental triggers, oxidative stress pathways, emerging depigmenting agents, laser and microneedling technologies, combination therapies, and advances in precision medicine.  \nResults: Melasma arises from dysregulated melanogenesis involving hyperactive melanocytes, hormonal stimulation, UVinduced oxidative stress, dermal inflammation, fibroblast senescence, and pigmentary incontinence. Innovations include nonhydroquinone brighteners (e.g., thiamidol, melasyl), antioxidants, tranexamic acid, and improved topical delivery systems. Procedural advances—such as low-fluence picosecond lasers, fractional CO2 laser–assisted drug delivery, chemical peel hybrids, and exosome-augmented microneedling—offer enhanced pigment clearance with improved safety profiles. Nevertheless, treatment durability remains limited by relapse, heterogeneous disease subtypes, PIH risk, and inconsistent adherence. Conclusions: Melasma management is evolving toward multi-target, combination-based strategies addressing pigmentation, inflammation, and photoaging simultaneously. Emerging regenerative technologies, biomarker-driven personalization, and AIassisted assessment hold promise for improving long-term outcomes, though standardized protocols and long-term safety data are still needed.  \n\n| Ting Liao and Rui Luo contributed equally to this study. |\n| --- |\n| This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.\u003Cbr>© 2026 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC. |\n\nJournal of Cosmetic Dermatology, 2026; 25:e70665 1 of 14  \n[https://doi.org/10.1111/jocd.70665](https://doi.org/10.1111/jocd.70665)  \n1 | Introduction  \n1.1 | Why Compose This Literature Review?  \nMelasma is one of the most common and widespread forms of hyperpigmentation, especially in women, and is predominantly seen in individuals with darker skin types (Fitzpatrick skin types III–VI) [1] . Although it is not a life-threatening condition, its psychological and social impacts can be profound. Studies [2–4] consistently report that individuals with melasma experience a decrease in self-esteem, confidence, and quality of life due to the visible and persistent","cbCaih6gppwV0NjC","https://ap.wps.com/l/cbCaih6gppwV0NjC","pdf",565525,14,"English","# Introduction\n## Why Compose This Literature Review?\n## What Has Been Known?","[{\"question\":\"What factors drive melasma development and recurrence?\",\"answer\":\"Melasma is driven by interactions among genetic predisposition, hormonal fluctuations, UV exposure, oxidative stress, inflammation, and photoaging, leading to dysregulated melanogenesis and high relapse risk.\"},{\"question\":\"What innovations are highlighted for melasma treatment?\",\"answer\":\"The review highlights newer topical brighteners and antioxidants, tranexamic acid, improved topical delivery systems, and procedural options such as low-fluence picosecond lasers and fractional CO2 laser–assisted drug delivery.\"},{\"question\":\"Why is achieving durable treatment control still difficult?\",\"answer\":\"Durability is limited by relapse, heterogeneous subtypes, risks such as post-inflammatory hyperpigmentation, and inconsistent adherence to treatment regimens.\"}]","Targeting Melasma - Innovations in Pigment Deposition and Photoaging in Cosmetic Dermatology | PDF",1790759628,35]