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Most obviously, the substance can cause muscles to become abnormally shaped, but The side effects of Synthol are manifold and they can also cause damage of nerves, oil embolic of the pulmonary, occlusion of the pulmonary artery, myocardial infarction, cerebral stroke, and infectious complications, according to the review

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However, for melasma specifically, the strongest clinical evidence supports chemical peels, laser toning, topical depigmenting agents and oral tranexamic acid

Chronic hypoxia is common in life and includes environmental hypoxia, such as altitude exposure, and hypoxia of the body or organs during aging and disease [21]