ReviewCureus2026
Innovations in Refractory Melasma: Mechanism-Based Management and Emerging Therapeutic Strategies.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Melasma is a common, chronic, acquired disorder characterized by hyperpigmentation, predominantly affecting women. Although its exact pathophysiology is unknown, multiple factors affect its pathogenic process since it's considered a multifactorial disease. This review provides an updated narrative synthesis of the epidemiology, pathophysiology, diagnostic approaches, and current management strategies for melasma, with emphasis on emerging therapeutic modalities, including approaches for refractory disease, and clinically relevant insights. This narrative review was conducted following the Scale for the Assessment of Narrative Review Articles (SANRA) to ensure methodological rigor. A comprehensive literature search was performed across multiple databases, focusing on peer-reviewed studies addressing melasma pathogenesis, diagnosis, and treatment. The findings were synthesized qualitatively. The pathogenesis of melasma involves complex interactions between ultraviolet radiation, hormonal modulation, dermal remodeling, inflammation, mast-cell activity, and stem cell signaling. Its diagnosis is primarily clinical and may be supported by Wood's lamp examination or dermoscopy. Management of melasma requires a multimodal approach, with strict photoprotection as the foundation. Therapeutic options include topical depigmenting agents, systemic therapies, chemical peels, microneedling, laser and light-based treatments, and platelet-rich plasma, and emerging combination and drug delivery strategies for refractory melasma, selected based on disease severity, skin type, and risk of recurrence. Melasma remains a challenging and recurrent pigmentary disorder. Individualized, combination-based treatment strategies grounded in photoprotection and informed by evolving pathogenic insights offer the best potential for sustained clinical improvement, particularly in patients with refractory disease. Continued research is essential to optimize long-term outcomes and quality of life.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.