黄褐斑的药物治疗进展

Advances in the medication treatment of melasma

黄褐斑是临床常见的获得性色素沉着性疾病，病因不明，尚元特效疗法，目前以药物治疗为主，抑制黑素生成是主要的作用机制，包括抑制酪氨酸酶合成、抑制黑素小体转运、加速表皮更新等，其中以酪氨酸酶抑制剂使用最为广泛；植物萃取物在治疗黄褐斑方面仍缺乏足够证据。应用明确有效的治疗及安全合适的维持治疗方案是主要治疗原则。随着对黄褐斑发病机制的进一步研究及基因工程药物的出现可能为本病的治疗带来新思路。

Melasma is a common acquired pigmentation disorder in clinic. The etiology of melasma remains unknown, and there is still no satisfying therapy. Medication treatment is the primary therapy for melasma at present, which mainly inhibits melanogenesis via suppressing tyrosinase synthesis, preventing melanosome transport to keratinocytes, and accelerating epidermal turnover. Tyrosinase inhibitors are the most widely used medication, whereas there is still no enough evidence for the application of plant extracts in the treatment of melasma. Treatment principles of melasma mainly include utilization of definitely effective therapy as well as safe and appropriate maintenance regimens. Further insights into the pathogenesis of melasma and the advent of genetic engineering therapy may provide new ideas for the treatment of melasma. [Key words] Chloasma; Drug therapy, combination