Nutrological control and treatment of melasma in the COVID-19 pandemic: a concise systematic review

Abstract

Introduction: In the skin disease scenario, hyperpigmentation (melasma) is present in about 14.5%-56% of pregnant women and 11.3%-46% of people taking oral contraceptives worldwide. The coronavirus disease 2019 (COVID-19) pandemic has brought great challenges to the treatment of melasma, as well as doubts about its worsening. Diet and nutrients for topical or oral use play an important role in the control of infectious diseases. Objective: It was to perform a concise systematic review on the occurrence, worsening, and nutrological treatment of melasma in the COVID-19 pandemic. Methods: The present study followed a systematic review model (PRISMA). After literary search criteria using MeSH Terms, a total of 98 clinical studies were compared and submitted to eligibility analysis and, after that, 70 studies were selected. The search strategy was carried out in the databases PubMed, Embase, Ovid and Cochrane Library, Web Of Science, ScienceDirect Journals (Elsevier), Scopus (Elsevier), OneFile. Results and Conclusion: Melasma is an acquired hyperpigmentation disorder, and reactive oxygen species play an important role in the regulation of melanin synthesis. In nutrological terms, lycopene is one of the most effective oxygen neutralizers among tomato-derived carotenoids. Furthermore, hydroquinone is a compound that has been used for the treatment of hyperpigmentation by tyrosinase inhibition mechanism and can be found in wheat. Thus, an adequate knowledge of the role of nutritional supplements in dermatological diseases can be a useful tool. Based on this, there is growing interest in oral medications and dietary supplements to improve melasma. Oral medications and dietary supplements evaluated include tranexamic acid, Polypodium leucotomos extract, beta-carotenoid, melatonin, and procyanidin. Also, hydrolyzed collagen is a low molecular weight protein that has been widely used and can prevent melasma. Serum zinc levels can also predict the occurrence of melasma. Finally, there is still no report on skin darkening associated with COVID-19.