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The Impact of Antioxidants on Vitiligo and Melasma: A Scoping Review and Meta-Analysis.

  • 2023-12-06
  • Antioxidants (Basel, Switzerland) 12(12)
    • Reinhart Speeckaert
    • Vedrana Bulat
    • Marijn M Speeckaert
    • Nanja van Geel

Study Design

Type
Meta-Analysis
Population
patients with vitiligo and/or melasma
Methods
Systematic search on Embase and Pubmed, meta-analysis
Reactive oxygen species (ROS) generated during melanogenesis make melanocytes particularly vulnerable to oxidative stress, influencing their survival and melanin synthesis. Oxidative stress, significantly present in vitiligo and recently also detected in melasma, triggers inflammatory cascades and melanogenesis, making antioxidants a promising therapeutic avenue. A systematic search was conducted on Embase and Pubmed to study the efficacy of antioxidants for treating vitiligo and/or melasma. Meta-analysis was performed to assess the difference in Melasma Severity Index (MASI) scores between baseline and follow-up. Various antioxidants like polypodium leucotomos, ginkgo biloba, catalase/superoxide dismutase, and vitamin E have potential in vitiligo. For melasma, vitamin C, silymarin, and niacinamide were among those showing promise in reducing pigmentation, with vitamin C displaying significant effects in meta-analysis. Different antioxidants improve both vitiligo and melasma, with an increased minimal erythema dose (MED) following UV exposure being significant for vitiligo and tyrosinase inhibition being crucial for melasma. However, the efficacy of individual antioxidants varies, and their exact mechanisms, especially in stimulating melanocyte proliferation and anti-inflammatory pathways, require further investigation to understand better and optimize their use.

Research Insights

  • Ginkgo→Reduced Vitiligo Severity

    Various antioxidants like polypodium leucotomos, ginkgo biloba, catalase/superoxide dismutase, and vitamin E have potential in vitiligo.

    Effect
    Beneficial
    Effect size
    Small
  • Polypodium Leucotomos→Reduced Vitiligo Severity

    Various antioxidants like polypodium leucotomos, ginkgo biloba, catalase/superoxide dismutase, and vitamin E have potential in vitiligo.

    Effect
    Beneficial
    Effect size
    Small
  • Thistle→Reduced Melasma Severity

    For melasma, vitamin C, silymarin, and niacinamide were among those showing promise in reducing pigmentation, with vitamin C displaying significant effects in meta-analysis.

    Effect
    Beneficial
    Effect size
    Small
  • Vitamin B3→Reduced Melasma Severity

    For melasma, vitamin C, silymarin, and niacinamide were among those showing promise in reducing pigmentation, with vitamin C displaying significant effects in meta-analysis.

    Effect
    Beneficial
    Effect size
    Small
  • Vitamin C→Reduced Melasma Severity

    For melasma, vitamin C, silymarin, and niacinamide were among those showing promise in reducing pigmentation, with vitamin C displaying significant effects in meta-analysis.

    Effect
    Beneficial
    Effect size
    Small
  • Vitamin E→Reduced Vitiligo Severity

    Various antioxidants like polypodium leucotomos, ginkgo biloba, catalase/superoxide dismutase, and vitamin E have potential in vitiligo.

    Effect
    Beneficial
    Effect size
    Small
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