Table 1.
Characteristics of included studies.
| Study | Country | Sample size (% female) and characteristics | Interventions | Duration (weeks) | Outcomes | Adverse events |
|---|---|---|---|---|---|---|
| Alvin et al. (23) | Philippines | Size: 50 (98%) Age: 44.5 ± 7.5 (25–60) Melasma type: epidermal, mixed Melisma duration: 0–5 years |
Oil (Mulberry) Vs. Placebo |
8 | MASI Mexameter reading Self-evaluation |
EG: 16% 4 × mild itching CG: 48% 8 × mild pruritus 4 × mild erythema |
| Bavarsad et al. (24) | Iran | Size: 22 (100%) Age: 34.10 ± 8.99 Melasma type: epidermal, dermal, mixed Melisma duration: 210 ± 118 weeks |
Cream (Lycopene and Wheat bran) Vs. Placebo |
12 | MASI Discoloration rate Area of melasma Self-evaluation |
0% |
| Costa et al. (25) | Brazil | Size: 56 (100%) Age: 18–60 Melasma type: epidermal, mixed Melisma duration: NR |
Cream (Emblica, Licorice and Belides) Vs. Cream (2% HQ) |
12 | Medical evaluation Self-evaluation UV spots Manchas UV |
EG: 8.7% 2 × burning & increase of previous acne lesions CG: 26.9% 7 × erythema & burning & erythematous papules in the perioral region |
| Francisco-Diaz et al. (26) | Philippines | Size: 52 (84.6%) Age: 18–60 Melasma type: mixted Melisma duration: 3.75 years (mean) |
Solution (Malva sylvestris, Mentha piperita, Primula veris, Alchemilia vulgaris, Achillea millefolium, Mellissa officinales) Vs. Placebo |
12 | mMASI Area of melasma Light reflectance |
0% |
| He et al. (27) | China | Size: 70 (100%) Age: 24–52 Melasma type: NR Melisma duration: 0.5–20 years |
Cream (herbal medicines) Vs. Placebo |
8 | MASI Medical evaluation |
0% |
| Javedan et al. (28) | Iran | Size: 60 (81.6%) Age: 32.18 ± 8.69 (26–55) Melasma type: NR Melisma duration: NR |
Cream (Dorema ammoniacum) Vs. Placebo |
4 | mMASI | 0% |
| Khosravan et al. (29) | Iran | Size: 70 (100%) Age: 19–55 Melasma type: epidermal Melisma duration: NR |
Parsley brewed Vs. Cream (4% HQ) |
8 | MASI |
EG: 7.4% 2 × redness & itching CG: 7.4% 2 × redness & itching |
| Mahjour et al. (30) | Iran | Size: 40 (100%) Age: 18–59 Melasma type: NR Melisma duration: NR |
Cream (C. Aritinum L. and C. melo var. inodorus H.Jacq) Vs. Cream (4% HQ) |
12 | MASI Self-evaluation |
EG: 3.1% 1 × acne CG: 15.6% 3 × erythema 1 × ecne 1 × erythema & dryness & scaling |
| Mendoza et al. (31) | Philippines | Size: 45 (62.2%) Age: 29.04 ± 7.8 (18–50) Melasma type: epidermal, mixed Melisma duration: NR |
Cream (Rumex occidentalis) Vs. 1. Cream (4% HQ) 2. Placebo |
8 | MASI Mexameter reading Medical evaluation Self-evaluation |
EG: 6.7% 1 × mild peeling CG1: 0% CG2: 0% |
| Morag et al. (32) | Poland | Size: 50 (100%) Age: 37.67 ± 7.53 (26–55) Melasma type: NR Melisma duration: NR |
Cream (Five-leaf serratula) Vs. Placebo |
8 | Mexameter reading | 0% |
| Zhang et al. (33) | China | Size: 90 (NR) Age: 40.35 ± 6.02 (25–50) Melasma type: NR Melisma duration: 5.46 ± 3.72 years |
Cream (China camellia, sanchi, Prinsepia utilis oil, and Portulaca oleracea) Vs. 1. Cream (arbutin) 2. Placebo |
12 | MASI Mexameter reading Inflammatory cells Self-evaluation |
EG: 0% CG1: 6.7% 2 × slight erythema and pruritus CG2: 0% |
| Zubair et al. (34) | Pakistan | Size: 90 (96.7%) Age: 29.31 ± 6.47 (18–40) Melasma type: epidermal Melisma duration: 5.80 ± 3.93 years |
Cream (4% Liquiritin) Cream (2% Liquiritin) Vs. Cream (4% HQ) |
8 | Medical evaluation |
EG: 0% CG: 10% 2 × contact dermatitis 1 × hyperpigmentation |