Comparison of 4% Topical Hydroquinone versus Combination of Oral Tranexamic Acid and 4% Topical Hydroquinone in the Treatment of Epidermal Melasma (original) (raw)
Related papers
Topical tranexamic acid versus hydroquinone for patients presenting with melasma
Journal of Pakistan Association of Dermatology, 2019
Objective To compare the outcome with topical tranexamic acid versus hydroquinone for management of patients presenting with melasma. Methods The present study was conducted in the outpatient department of dermatology unit 1. 354 patients fulfilling selection criteria were enrolled and divided in two groups. In group A, patients were prescribed topical cream of 5% TA and in group B, patients were prescribed topical cream of 2% hydroquinone. MASI score was assessed at presentation and at 4 weeks of follow up. Results In this study the mean age of cases in Tranexamic acid group was 35.42±10.68 years and in Hydroquinone group was 36.25 ±10.42 years. In Tranexamic acid there were 13(7.3%) male and 164(92.7%) female cases and in Hydroquinone group there were 26(14.7%) male and 151(85.3%) female cases. Mean duration of pigmentation in Tranexamic acid group was 6.45±3.10 months and in Hydroquinone group was 6.50±3.02 months. The mean MASI score at baseline in Tranexamic acid group was 36.1...
Serbian Journal of Dermatology and Venereology, 2019
Introduction. Melasma is a common skin pigmentation disorder affecting a patient’s life psychologically and socially. Topical medications or lasers can have temporary and limited therapeutic effects on melasma. Material and Methods. This study is a prospective clinical trial comparing therapeutic effects of oral Tranexamic acid (TXA) and topical Hydroquinone (HQ) cream. A total number of 69 patients were examined. During the study, 10 patients failed to appear for the follow-up and 59 of them completed the trial. The patients were also divided randomly into two groups. Group A received TXA capsule 250 mg every 12 hours and group B received 4% topical HQ cream day and night. The patients from both groups were treated for 3 months. Melasma Area and Severity Index (MASI) scores were then calculated at the baseline, 4 weeks, and 12 weeks into the treatment and 3 months after the end of intervention. Results. MASI baseline, 4 weeks,12 weeks, and 24 weeks in TXA group were 21.66, 13.69, 9...
Dermatology and Therapy, 2017
IntroductionFew studies have focused on therapeutic as well as side effects of tranexamic acid (TXA) as a topical drug compared to other topical drugs in treating melasma. The present study aimed to assess and compare the beneficial therapeutic effects and also side effects of local TXA in comparison with hydroquinone in treating women with melasma.MethodsThis randomized double-blinded clinical trial was performed on 60 women who suffered from melasma and were referred to the skin disorders clinic at the Rasoul-e-Akram hospital in Tehran in 2015. The patients were then randomly assigned via computerized randomization to two groups: group A received TXA%5 (topically twice a day for 12 weeks in the location of the melasma) and group B (received hydroquinone 2% with the same treatment order). Prior to intervention and at 12 weeks after intervention, the intensity and extension of melasma were assessed based on the Melasma Area and Severity Index (MASI) scoring method.ResultsThe mean MA...
Clinical, Cosmetic and Investigational Dermatology, 2019
Background: Melasma is a common benign acquired pigmentary dermatosis due to a disorder in the function of the melanogenesis process. Although several treatments are currently used, it remains a great challenge. Aim: The aim of this study is to compare the efficacy of intradermal injected tranexamic acid (TA) vs hydroquinone (HQ) cream in the treatment of melasma. Materials and methods: In this prospective split face controlled clinical trial, 49 patients were randomly divided into two groups of A (24 persons) and B (25 persons). Patients received TA intradermal injections every 2 weeks on the right side of the face with a concentration of 4 mg/ mL in group A and a concentration of 10 mg/mL in group B. The left side in both groups was treated twice daily with topical 4% HQ cream, and treatment continued for 12 weeks in both groups. Melasma Area and Severity Index (MASI) scores were measured for each side of the face at baseline and at weeks 4, 8, 12, and 24. SPSS, version 22, P<0.05, was used for data analysis. Results: Forty-one patients (21 in group A and 20 in group B) completed the study. The MASI score in the 12th week significantly decreased compared to the baseline for group A, group B, and HQ cream. However, no statistically significant difference was observed between the MASI score of patients in groups A and B. Also, the comparison of TA at the concentration of 4 mg/ mL compared to the 4% HQ cream showed that the MASI scores in the eighth week (P=0.02) and the 12th week (P=0.02) were significantly less in the HQ group. However, no significant difference was observed between the MASI score changes in Group B (10 mg/mL) and the 4% HQ group. Also, patients in group A had higher satisfaction than patients in group B (P=0.001). Conclusion: Injection of TA intradermally can be an effective treatment for melasma.
Berkala Ilmu Kesehatan Kulit dan Kelamin
Background: Melasma is a hyperpigmentation disorder that affects the quality of life, especially in women. Hydroquinone has remained the mainstay of melasma treatment. However, its safety for long-term usage became a great concern. Combination therapy, such as niacinamide and kojic acid, can be used as an alternative melasma treatment due to different mechanisms of action and synergism. Purpose: The aim of this study was to compare the efficacy and safety of a combination of 4% niacinamide and 4% kojic acid (N-K) vs. 4% hydroquinone (HQ) in epidermal melasma. Methods: This was a randomized, double blind, clinical study on 13 female epidermal melasma patients at the Cosmetic Dermatology Outpatient Clinic of Dr. Hasan Sadikin Hospital, Bandung. Patients received two creams, a combination of N-K and HQ, for split-face therapy, regardless of the sides of the face. All patients were followed up at 4 and 8 weeks. The clinical efficacy was assessed for skin lightening effects using a spect...
Journal of Cosmetic Dermatology, 2011
Background Melasma is an irregular brown or grayish-brown symmetric facial hypermelanosis, often affecting women, especially those living in areas with intense ultraviolet radiation. Objective Comparison of therapeutic effects of 20% azelaic acid and 4% hydroquinone cream in the treatment of melasma. Methods Twenty-nine women with melasma were recruited. Fifteen patients were treated with 4% hydroquinone cream and 14 patients were treated with azelaic acid cream for 2 months. The cream was applied twice daily. A broad-spectrum sunscreen was used concomitantly by both groups. The Melasma Area Severity Index (MASI) scores were determined prior to treatment and at each follow-up. Results The mean MASI score before treatment was 7.2 ± 3.2 in the hydroquinone group and 7.6 ± 3.5 in the azelaic acid group, with no significant difference between them (t-test, CI 95% = )2.9 to 2.2). One month after treatment, the mean MASI score reached 6.7 ± 3.4 with hydroquinone and 6.3 ± 3.4 with azelaic acid with no significant difference between them (t-test, CI 95% = )2.2 to 3). After 2 months' treatment, the MASI score was 6.2 ± 3.6 with hydroquinone and 3.8 ± 2.8 with azelaic acid, a significant statistical difference (t-test, CI 95% = 0.03-4.9). Conclusions In conclusion, this study suggests that 20% azelaic acid cream applied twice daily may be more effective than hydroquinone 4% in reducing mild melasma. However, because this was an open trial, it is suggested that further studies involving large groups of patients be conducted to achieve a more conclusive result.
Bangladesh Journal of Medical Science, 2012
Background & Methodology: It was an opened clinical trial. The study was carried out from March 2009 to February 2011, in the outpatient department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka, Bangladesh to evaluate the efficacy and side effects of the combination therapy of hydroquinone(HQ), kojic acid(KA) and glycolic acid(GA) for the treatment of melasma. Patients suffering from melasma were selected as study population. Within the period of data collection, thirty patients of melasma were assigned purposively. The efficacy was evaluated using Melasma Area and Severity Index (MASI) Score. The severity of melasma of each of the four regions (forehead, right malar region, left malar region and chin) are assessed based on three variables, percentage of the total area involved (A), darkness (D) and homogenicity (H).Results:The study showed that majority (30%) of the cases were between 20 to 25 years, majority (77%) of patients were f...
Clinical, Cosmetic and Investigational Dermatology
Background: Melasma is the most common pigmentary skin disorder, especially in females and those with darker complexion. The current study evaluated the safety and efficacy of a triple combination cream containing hydroquinone 4%+tretinoin 0.05%+fluocinolone acetonide 0.01% (Januluma ® cream produced by Janus Pharmaceutical Co, Tehran, Iran) in the treatment of melasma. Patients and methods: Twenty-two female volunteers (mean±standard deviation of age: 39.20±4.16 years) who fulfilled the eligibility criteria participated in this study after signing the informed consent. They were requested to apply the Januluma ® cream every night for 8 weeks. Modified melasma area and severity index (mMASI), skin lightness (L value), and severity of pigmentation (E value) by Visio Face, and skin biophysical parameters including pH, melanin index, erythema index, sebum, hydration, trans epidermal water loss, thickness and density of epidermis, and dermis (using 22 MHz ultrasonography) were measured before and 4 and 8 weeks after treatment. Also patients' satisfaction was assessed 4 and 8 weeks after treatment using visual analog score. Results: mMASI decreased significantly from 3.37 to 2.60 at week 4, and to 2.40 at week 8 (P-values=0.00 and 0.01, respectively). Also, E and L values improved significantly after 8 weeks of treatment (P=0.01 and 0.00, respectively). Skin melanin index decreased from 237.49 AU to 196.30 AU at week 8 (P=0.01). Also echo density of dermis increased significantly after 8 weeks of treatment (P=0.029). Almost all participants experienced some degrees of pruritus, scaling, and erythema, esspecially during the first month of application, which were generally mild and tolerable. The mean satisfaction of patients with the treatment was 6.77. Conclusion: The triple combination formula was reasonably safe and effective for treatment of melasma in Middle Eastern patients.
Journal of Pharmaceutical Research International
Aim: To compare the efficacy and safety of topical 3% tranexamic acid gel vs 35% glycolic acid peel in the treatment of melasma over face. Materials and Methods: This is an open labelled, Randomised Controlled Trial(RCT) conducted on 60 patients. Patients were randomly divided equally into 2 groups – Group A and Group B. Patients of Group A used topical 3% tranexamic acid gel twice a day and Group B patients were treated with 35% glycolic acid peel with a contact period of 5 minutes once in every 2 weeks. Patients were assessed every month for a period of 3 months and recurrence was assessed for the next consecutive 3 months following the treatment. Patients were asked to use a broad spectrum sunscreen before sun exposure during the entire study. Assessment of reduction in pigmentation was made by MASI score, subjective and objective valuation (blind observer) and photographic comparison. Safety profile was assessed by the side effects. Results: The mean value of Melasma Area and S...