MELASMA GESTATION AND HORMONAL INFLUENCE: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.56238/levv17n59-047Keywords:
Melasma, Pregnancy, Hormones, HyperpigmentationAbstract
Introduction: Melasma is a common acquired hyperpigmentation disorder strongly influenced by hormonal changes, particularly during pregnancy, where fluctuations in estrogen, progesterone, and melanocyte-stimulating hormone contribute to increased melanogenesis and lesion development.
Objective: The main objective of this systematic review was to evaluate the role of gestational hormonal changes in the pathogenesis and progression of melasma. Secondary objectives included analyzing molecular mechanisms of hormone-induced melanogenesis, comparing clinical severity between pregnant and non-pregnant populations, assessing psychosocial impact, and identifying gaps in current evidence and therapeutic approaches.
Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, and ICTRP. Studies published within the last five years, extendable to ten years if necessary, were included without language restrictions.
Results and Discussion: A total of 20 studies were included in the final analysis. The evidence consistently demonstrated that hormonal fluctuations during pregnancy significantly increase melanocyte activity, tyrosinase expression, and pigmentation severity. Estrogen receptor upregulation, progesterone synergy, angiogenesis, and oxidative stress were identified as key mechanisms contributing to disease onset and persistence. Clinical findings showed higher prevalence and severity during pregnancy, with frequent postpartum recurrence and substantial psychosocial impact.
Conclusion: Melasma gravidarum is a multifactorial condition primarily driven by hormonal influences, with important contributions from vascular and oxidative pathways. Preventive strategies, especially photoprotection, remain the cornerstone of management during pregnancy.
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