Newer botanicals in melasma: A review

Melasma is a common acquired pigmentary disorder predominantly affecting women of childbearing age and Fitzpatrick skin types IV-VI. It negatively impacts the quality of life due to its chronic and relapsing nature. It occurs due to a complex interplay between genetics, hormonal influences, inflammation, oxidative stress, and chronic photodamage. Therefore, a multimodality approach is essential for its treatment. It encompasses photoprotection, topical and oral therapy, and various procedures such as chemical peels, microneedling, lasers, and light treatment. The gold-standard treatment remains topical modified Kligman's formula, consisting of hydroquinone, corticosteroid, and retinoid, in different concentrations. However, it may cause various adverse effects due to its unsupervised and chronic use. Therefore, novel treatment modalities should not only focus on reducing melanin synthesis and other influencing factors but also have a high safety profile. Among them, botanicals or plant-based extracts have gained massive popularity in the recent past. These compounds have been investigated extensively for their therapeutic activity against pigmentation, efficacy, and safety. Currently, they act as adjuncts to existing topicals. However, there is a paucity of data for their use as monotherapy. This review focuses on newer as well as existing botanicals for the treatment of melasma. Data extraction was done by searching words like botanicals, plant extracts, melasma, and depigmenting agents in databases: Pubmed, Google Scholar, Scopus, and others over the last 20 years.