PMID- 35141245
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220501
IS  - 2296-858X (Print)
IS  - 2296-858X (Electronic)
IS  - 2296-858X (Linking)
VI  - 8
DP  - 2021
TI  - Efficacy and Safety of Topical Therapy With Botanical Products for Melasma: A 
      Systematic Review and Meta-Analysis of Randomized Controlled Trials.
PG  - 797890
LID - 10.3389/fmed.2021.797890 [doi]
LID - 797890
AB  - Botanical products have been increasingly popular in topical therapies for 
      melasma, as presumed safer and milder than fully synthetic products. Although the 
      efficacy of different topical botanicals has recently been substantiated through 
      randomized controlled trials (RCTs), there is a lack of sufficiently pooled 
      evidence on their efficacy and safety for the treatment of melasma. Herein, a 
      systematic review and meta-analysis was conducted on the efficacy and safety of 
      topical botanical products for the treatment of melasma, following Preferred 
      Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). All RCTs on 
      the use of topical botanical products for the treatment of melasma in humans were 
      included, except for trials enrolling pregnant patients. The primary outcome was 
      Melasma Area and Severity Index (MASI) or its variation. The secondary outcomes 
      included Mexameter((R)) reading, melasma improvement evaluated by participants, and 
      any reported adverse events (AEs). As a result, twelve eligible trials comprising 
      695 patients with melasma from 6 different countries were included. The topical 
      botanical products contained active ingredients which varied among trials as 
      follows: herb-derived molecule, extracts of a single herb, and extracts of 
      compound herbs. Topical therapy with botanical products significantly improved 
      melasma with a large effect on MASI reduction (SMD -0.79, 95% CI -1.14 to -0.44, 
      p < 0.00001), and a moderate effect on Mexameter((R)) reading reduction (SMD -0.52, 
      95% CI -0.81 to 0.23, p = 0.0005), when compared with placebo. It also showed a 
      similar improvement of melasma with a better safety profile (RR 0.37, 95% CI 
      0.15-0.88, p = 0.02), when compared with active-comparators. Botanical products 
      were well-tolerated across studies, with no serious AEs reported. Despite the 
      limitations such as small sample size, short duration of follow up and varied 
      botanical products, this work still represents the best level of evidence 
      currently available on topical use of botanical products on melasma. Moreover, it 
      should be noted that more well-designed studies are needed before recommending 
      topical botanical products as a viable treatment option for melasma. SYSTEMATIC 
      REVIEW REGISTRATION: PROSPERO, identifier: CRD42021256328.
CI  - Copyright (c) 2022 Wang, Wang, Wang, Chen, Qu and Li.
FAU - Wang, Tianyun
AU  - Wang T
AD  - Department of Endocrinology, Huaian Hospital, Huaian, China.
AD  - Department of Pharmacy, Huaian Hospital, Huaian, China.
FAU - Wang, Youmei
AU  - Wang Y
AD  - Department of Endocrinology, Huaian Hospital, Huaian, China.
AD  - Department of Pharmacy, Huaian Hospital, Huaian, China.
FAU - Wang, Jue
AU  - Wang J
AD  - State Key Laboratory of Quality Research in Chinese Medicines, Macau University 
      of Science and Technology, Macau, China.
FAU - Chen, Hongwei
AU  - Chen H
AD  - School of Public Health, Sun Yat-sen University, Shenzhen, China.
FAU - Qu, Biao
AU  - Qu B
AD  - State Key Laboratory of Quality Research in Chinese Medicines, Macau University 
      of Science and Technology, Macau, China.
FAU - Li, Zheng
AU  - Li Z
AD  - Jiangsu Engineering Research Center of Cardiovascular Drugs Targeting Endothelial 
      Cells, School of Life Sciences, College of Health Sciences, Jiangsu Normal 
      University, Xuzhou, China.
AD  - State Key Laboratory of Natural and Biomimetic Drugs, Peking University, Beijing, 
      China.
LA  - eng
PT  - Systematic Review
DEP - 20220124
PL  - Switzerland
TA  - Front Med (Lausanne)
JT  - Frontiers in medicine
JID - 101648047
PMC - PMC8819825
OTO - NOTNLM
OT  - botanical products
OT  - efficacy
OT  - melasma
OT  - meta-analysis
OT  - safety
OT  - systematic review
OT  - topical therapy
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/02/11 06:00
MHDA- 2022/02/11 06:01
PMCR- 2022/01/24
CRDT- 2022/02/10 05:38
PHST- 2021/10/19 00:00 [received]
PHST- 2021/12/27 00:00 [accepted]
PHST- 2022/02/10 05:38 [entrez]
PHST- 2022/02/11 06:00 [pubmed]
PHST- 2022/02/11 06:01 [medline]
PHST- 2022/01/24 00:00 [pmc-release]
AID - 10.3389/fmed.2021.797890 [doi]
PST - epublish
SO  - Front Med (Lausanne). 2022 Jan 24;8:797890. doi: 10.3389/fmed.2021.797890. 
      eCollection 2021.