Melasma: advances in pathophysiology and innovative therapeutic strategies based on natural bioactives and nanotechnology

Resumo

Melasma is a chronic and multifactorial pigmentary disorder characterized by recurrent skin hyperpigmentation, strongly associated with oxidative stress, inflammation, and melanocytic hyperactivity induced mainly by ultraviolet radiation, genetic predisposition, and hormonal alterations. Despite available conventional therapies, high recurrence rates and adverse effects highlight the need for safer and more innovative approaches. This study aimed to analyze advances in the pathophysiological understanding of melasma, discuss limitations of current therapies, evaluate the potential of natural bioactive compounds as antioxidant and depigmenting agents, and examine the applicability of nanostructured systems to optimize cutaneous delivery. A narrative literature review was conducted using PubMed and Scopus databases, including original articles without temporal restriction. Thematic analysis showed that oxidative stress and inflammation play central roles in maintaining hyperpigmentation, while flavonoids and other phenolic compounds demonstrate melanogenesis-modulating potential. In addition, nanostructured systems have shown promise in improving the stability, bioavailability, and therapeutic efficacy of these bioactives. In conclusion, the integration of natural bioactives and nanotechnology represents an innovative and pathophysiologically grounded strategy for melasma management.