Oral Melatonin: An Unexpected Treatment for Melasma?

Understanding Melatonin

Melatonin is a hormone naturally produced by the pineal gland in the brain. It plays a crucial role in regulating sleep-wake cycles, commonly known as circadian rhythms. As a supplement, melatonin is available over-the-counter (OTC) and is widely used to help manage sleep disorders, jet lag, and other conditions related to circadian rhythm disturbances. Recently, melatonin has garnered interest for its potential benefits in dermatology, particularly in the treatment of melasma.

What is Melasma?

Melasma is a common skin condition characterized by the appearance of dark, discolored patches, primarily on the face. It often affects areas such as the cheeks, forehead, nose, and upper lip, though it can also appear on other parts of the body. Melasma is more prevalent in women and is often triggered by factors like sun exposure, hormonal changes, and certain medications. The condition tends to have a relapsing and remitting course, making it a challenging issue to manage.

Traditional Treatments for Melasma

The management of melasma typically involves a combination of treatments, including:

  • Topical Creams: Often containing ingredients like hydroquinone, tretinoin, or corticosteroids.
  • Chemical Peels: These treatments exfoliate the skin to remove pigmented cells.
  • Oral Medications: Tranexamic acid is sometimes used to reduce pigmentation.
  • Sun Protection: Consistent use of sunscreen is crucial to prevent worsening of the condition.

Despite these options, some patients experience recalcitrant melasma, which does not respond adequately to traditional treatments.

Recent Study on Oral Melatonin for Melasma

A recent study explored the use of oral melatonin in patients with stubborn melasma. The study included seven patients who had not seen significant improvements with conventional treatments, such as topical creams, chemical peels, or oral tranexamic acid.

Study Highlights:

  • Participants: 7 patients with recalcitrant melasma.
  • Pre-treatment Phase: A 4-week washout period without any melasma treatments.
  • Treatment: Daily intake of 3-mg melatonin tablets for 12 weeks, alongside the use of sunscreen.
  • Outcomes: All patients reported a noticeable lightening of pigmentation. The Melasma Area and Severity Index (MASI) scores improved significantly from baseline.

Implications and Considerations

The findings suggest that oral melatonin could be a promising option for treating melasma, especially for patients who do not respond to traditional therapies. However, it is important to note that more extensive research is needed to confirm these results and establish standardized guidelines for using melatonin in melasma treatment.

Benefits of Oral Melatonin:

  • Well-Tolerated: Generally considered safe with minimal side effects.
  • Convenient: Easy to administer as an oral supplement.

Points to Consider:

  • Off-Label Use: Currently, melatonin is not officially approved for melasma treatment, so its use in this context is considered off-label.
  • Need for Further Research: More studies are required to understand the long-term effects and optimal dosing of melatonin for melasma.


Melasma remains a challenging condition to treat, but emerging therapies like oral melatonin offer hope for better management. If you are struggling with melasma, consult your dermatologist to discuss the potential benefits and risks of incorporating melatonin into your treatment plan. Always remember to use sunscreen diligently, as sun protection is a cornerstone of melasma management.


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