TERAPIAS COMBINADAS E USO DE ANTIOXIDANTES NO TRATAMENTO DO MELASMA: AVALIAÇÃO DA EFICÁCIA DA COMBINAÇÃO DE CLAREADORES TÓPICOS, PEELINGS, LASER E OUTROS AGENTES

Introduction: Melasma is characterized as a chronic skin hyperpigmentation disorder resulting from multiple factors and is challenging to manage. It is frequently associated with sun exposure, hormonal influences, and genetic predispositions. Effective treatment requires strategies that go beyond conventional topical depigmenting agents, incorporating chemical peels, laser therapies, and the application of antioxidants, which can enhance results and minimize adverse effects. Objective: To evaluate the efficacy of combined melasma treatment through the association of topical depigmenting agents, chemical peels, laser therapies, and antioxidants, comparing clinical response, safety, and treatment adherence. Method: This study is an integrative literature review, including original and review articles, to select relevant information for the outcome of this research. Results: The analysis of the studies revealed that combined therapy is more effective in reducing hyperpigmentation compared to the isolated use of depigmenting agents. The combination of hydroquinone with retinoic acid and corticosteroids proved to be effective in evening out skin tone. Additionally, the inclusion of antioxidants such as vitamin C and tranexamic acid contributed to reducing oxidative stress and inflammation. Chemical peels promoted controlled exfoliation and cellular renewal, while laser therapy and intense pulsed light resulted in significant improvements in cases of dermal melasma. Conclusion: The results obtained with combined therapy in the treatment of melasma indicate that this approach is more effective than isolated therapies, leading to better skin lightening and reducing recurrence rates. The inclusion of antioxidants has shown to be a promising strategy, improving treatment response and decreasing inflammation. However, it is crucial to personalize each treatment, considering the patient’s skin phototype, lesion depth, and sensitivity. Further studies are needed to establish optimal protocols that maximize benefits and minimize side effects.