LIFESTYLE MEDICINE FOR MELASMA MANAGEMENT: A NARRATIVE REVIEW OF MODIFIABLE BEHAVIORAL AND ENVIRONMENTAL FACTORS

Background: Melasma is a chronic acquired pigmentary disorder affecting an estimated 1% to 33% of the global population, with higher prevalence among individuals with darker skin phototypes in regions of intense ultraviolet exposure. Although pharmacological treatments including topical depigmenting agents and oral tranexamic acid remain the mainstay of therapy, high recurrence rates underscore the need for complementary strategies targeting modifiable risk factors. Lifestyle medicine, which emphasizes evidence-based behavioral interventions across six domains, offers a promising yet underexplored framework for melasma management. Objective: This narrative review aims to synthesize current evidence on modifiable behavioral and environmental factors that influence melasma onset, severity, and recurrence, and to propose an integrated lifestyle medicine framework for clinical application.