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Moreover, POX activity can result in immediate oxidative changes in the cellular environment by simultaneously depleting intracellular proline and producing superoxide (O 2 ) [137]

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Patients should seek urgent medical review if neurological symptoms worsen or fail to improve after 46 weeks of appropriate treatment

The best way to treat melasma depends upon the individual, but all treatment needs to include both active treatments to remove the pigment in the skin AND a proactive skincare and medication routine to prevent new pigment from developing