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First, it disrupts the process of melanin synthesis by inducing the release of high mobility group box 1 (HMGB1) protein, thus downregulating the melanin biosynthesis-related proteins: melanocyte-inducing transcription factor, tyrosinase, tyrosinase-related protein-1, tyrosinase-related protein-2, RAB27A and fascin actin-bundling protein 1 [17, 18]

Brownish/greyish coloured patches usually appear on the: cheeks forehead upper lip bridge of the nose chin Other areas of the body, that are often exposed to the sun, can also develop melasma such as the neck and forearms

The Centers for Disease Control and Prevention (CDC) advises that any changes in the appearance of injectable medications could indicate spoilage or contamination

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