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doi: 10.1300/J092v11n01_02 15 CarruthersBMvan de SandeMIDe MeirleirKLKlimasNGBroderickGMitchellTet al

In this study, histopathological examination of both right sides in two groups was of great value not only in confirming the type of melasma but also adding another objective tool in evaluation of treatment response in two groups, it demonstrated a decrease in melanin in basal cell layer in epidermal types and in melanin and melanophages in dermis in mixed types in H and E and MF stained sections after treatment compared with baseline

This may manifest as abdominal cramps, bloating, or loose stools