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Jonas Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India Nitin Joseph, Nithin Kumar, Rohith Motappa & Rekha Thapar Department of Economics, National Open University, Benin City, Nigeria Charity Ehimwenma Joshua Department of Family Medicine and Public Health, University of Opole, Opole, Poland Jacek Jerzy Jozwiak Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia Mikk Jrisson Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan Malik E

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Book an appointment if: Over-the-counter creams show no results after 12 weeks Pigmentation is spreading or darkening You want to start oral tranexamic acid or prescription-strength topicals You are considering chemical peels, lasers, or microneedling Melasma is affecting your confidence or mental health You have other skin conditions, like rosacea or post-inflammatory hyperpigmentation, that are complicating treatment Final Word Melasma treatment has advanced significantly in the past five years

DOI: 10.1056/NEJMoa063070 Aaron SD, Vandemheen KL, Fergusson D, et al

At the same time, in the treatment of NAFLD and non-alcoholic steatohepatitis [139, 140], nanoparticles encapsulated living bacteria can affect liver lipid metabolism and inflammatory response by improving intestinal flora imbalance and regulating the production of intestinal metabolites, such as SCFAs