TERAPIAS DE NOVA GERAÇÃO PARA O MELASMA ASSOCIADO A ALTERAÇÕES HORMONAIS: UMA REVISÃO INTEGRATIVA DA LITERATURA
NEXT-GENERATION THERAPIES FOR MELASMA ASSOCIATED WITH HORMONAL CHANGES: AN INTEGRATIVE LITERATURE REVIEW
DOI:
https://doi.org/10.37157/fimca.v13i1.1258Palavras-chave:
Melasma, Alterações Hormonais, Terapias Inovadoras, Hiperpigmentação Cutânea, Qualidade de Vida .Resumo
O melasma é uma dermatose hiperpigmentar crônica adquirida, caracterizada pelo surgimento de máculas acastanhadas em áreas fotoexpostas na face, acometendo predominantemente mulheres em idade reprodutiva. Sua etiopatogenia é multifatorial, envolvendo predisposição genética, exposição à radiação ultravioleta, fatores inflamatórios, alterações vasculares e, principalmente, influências hormonais relacionadas à gestação, uso de contraceptivos hormonais e terapia de reposição hormonal. O presente estudo teve como objetivo analisar as evidências científicas acerca das terapias de nova geração utilizadas no tratamento do melasma associado a alterações hormonais, bem como seus impactos clínicos e na qualidade de vida das pacientes. Trata-se de uma revisão integrativa da literatura realizada por meio de buscas nas bases de dados PubMed/MEDLINE, Scopus, SciELO e Biblioteca Virtual em Saúde (BVS), contemplando artigos publicados entre 2019 e 2026. Os resultados demonstraram avanços significativos no manejo terapêutico da doença, destacando-se o uso do ácido tranexâmico por vias oral, tópica e intradérmica, os lasers de picossegundos, microagulhamento associado a agentes despigmentantes, peelings químicos modernos e terapias combinadas. Essas abordagens apresentaram maior eficácia na redução da hiperpigmentação, menor taxa de recorrência e melhores índices de satisfação das pacientes quando comparadas aos tratamentos convencionais isolados. Além dos benefícios clínicos, observou-se melhora significativa da autoestima, da percepção da imagem corporal e da qualidade de vida. Conclui-se que as terapias de nova geração representam alternativas promissoras para o tratamento do melasma associado a alterações hormonais, reforçando a importância de abordagens individualizadas e multidisciplinares para o manejo dessa condição dermatológica de elevada prevalência e impacto psicossocial.
Palavras-chave: Melasma; Alterações Hormonais; Terapias Inovadoras; Hiperpigmentação Cutânea; Qualidade de Vida .
ABSTRACTMelasma is an acquired chronic hyperpigmentary dermatosis characterized by the appearance of brownish macules on sun-exposed areas of the face, predominantly affecting women of reproductive age. Its etiopathogenesis is multifactorial, involving genetic predisposition, ultraviolet radiation exposure, inflammatory factors, vascular changes, and—most notably—hormonal influences related to pregnancy, hormonal contraceptive use, and hormone replacement therapy. This study aimed to analyze scientific evidence regarding next-generation therapies used to treat melasma associated with hormonal changes, as well as their clinical impact and effects on patients' quality of life. It is an integrative literature review conducted via searches in the PubMed/MEDLINE, Scopus, SciELO, and Virtual Health Library (VHL) databases, covering articles published between 2019 and 2026. The results demonstrated significant advances in the therapeutic management of the disease, highlighting the use of tranexamic acid (via oral, topical, and intradermal routes), picosecond lasers, microneedling combined with depigmenting agents, modern chemical peels, and combination therapies. These approaches showed greater efficacy in reducing hyperpigmentation, lower recurrence rates, and higher patient satisfaction scores compared to conventional monotherapies. Beyond clinical benefits, significant improvements were observed in self-esteem, body image perception, and quality of life. It is concluded that next-generation therapies represent promising alternatives for treating melasma associated with hormonal changes, reinforcing the importance of individualized, multidisciplinary approaches to managing this dermatological condition, which has high prevalence and significant psychosocial impact.
Keywords: Melasma; Hormonal Changes; Tranexamic Acid; Cutaneous Hyperpigmentation; Quality of Life.
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