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Finally, some cosmetics, photosensitizing drugs (e.g., phenothiazines, sulfonamides, sulfonylureas, thiazide diuretics, tetracyclines, tricyclic antidepressants, promethazine, piroxicam), and steroid hormones (e.g., contraceptive pills, estrogen replacement therapies) increase the melanogenic effect of sun exposure and should be substituted to enable successful melasma treatment [2427]

Recent clinical data suggests they are well-tolerated , but they should only be used under medical supervision

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Individual results vary based on: Baseline weight Insulin sensitivity Hormonal status Nutrition and exercise habits Stress and sleep patterns GLP-1 therapy works best as part of a comprehensive metabolic plan, not as a stand-alone solution

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