Melasma and Pigmentary Disorders: Pathogenesis, Systemic Associations, and Emerging Treatment Strategies

Pigmentary disorders, including melasma, represent a significant dermatological challenge worldwide due to their multifactorial pathogenesis, aesthetic and psychosocial impact, and high rates of recurrence. Despite decades of research, the mechanistic understanding of these conditions remains incomplete. Recent investigations have identified a complex interplay between genetic predisposition, ultraviolet radiation, inflammation, oxidative stress, hormonal factors, and dermal microenvironment changes, all contributing to melanogenesis dysregulation. Studies have also uncovered associations between pigmentary disorders and systemic conditions such as metabolic syndrome, thyroid dysfunction, and hormonal imbalances, highlighting their wider clinical significance. However, existing therapeutic options are limited by inconsistent efficacy, potential side effects, and patient variability, necessitating further exploration of underlying pathways and novel treatment modalities.

This Research Topic aims to unify current knowledge on the pathophysiology, systemic associations, and treatment approaches for melasma and pigmentary disorders. It seeks to encourage contributions that explore molecular, hormonal, and environmental mechanisms of pigmentation disorders and to assess emerging therapeutic interventions including antioxidants, laser and light technologies, hormonal modulation, and regenerative treatments such as platelet-rich plasma and exosome-based therapies. Submissions examining the psychosocial burden, healthcare disparities, and quality-of-life outcomes related to pigmentary conditions are also encouraged, as these factors influence holistic management and long-term therapeutic success.

To gather further insights into the biological and clinical frameworks of pigmentary disorders, we welcome articles addressing, but not limited to, the following themes:

• Cellular and molecular mechanisms of melanogenesis in melasma and other pigmentary diseases
• Endocrine and metabolic contributors to dyschromic skin conditions
• Oxidative stress, inflammation, and endothelial dysfunction in pigmentation disorders
• Advances in topical, systemic, and device-based therapies for hyperpigmentation
• Role of regenerative and personalized medicine in pigment modulation
• Psychosocial and quality-of-life aspects of chronic pigmentary disorders
• Translational and clinical studies evaluating combination or adjunctive treatment regimens