الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
SUMMARY Melasma is a therapeutically challenging hypermelanosis which presents as symmetrically distributed brown macules in cheeks, forehead, upper lips, and the chin. Sometimes it affects extrafacial exposed skin as neck, chest and forearm. It is more common in females especially with dark skin types (Fitzpatrick skin type III-IV) and in hot tropical areas. Melasma is distributed in three clinical patterns centrofacial, the most common type, malar, and mandibular type. Pathogenesis and etiology is believed to be internal and environmental in origin, however it is not fully elucidated. The excessive pigmentation in melasma is suggested to be due to increase in both melanocyte proliferation and melanin secretion, also increased vascularity may play a role in the development of melasma. In addition to role of solar elastosis and cellular interaction based on cytokine complexes. There are multimodal approaches for melasma treatment, the hallmark in management of melasma is topical medications, also systemic treatment and minor procedures such as laser, chemical peeling, microinjection, and microneedling are considered next lines for treatment especially in resistant cases. Photoprotection is essential in melasma treatment. Silymarin is recently used in melasma. The exact mode of action of silymarin is not yet completely elucidated. Silibinin, the main component of silymarin, has powerful antioxidant and photoprotective effects