Abstract
Background – Numerous therapeutic options have been tried in the management of melasma. This prospective randomized study was planned to assess the efficacy of triple combination cream(TC-hydroquinone 2%/tretinoin 0.05%/flucinolone 0.01%) versus glycolic acid peels/ azelaic acid 20% cream (GA/AA) combination in melasma.
Materials and methods - Forty patients with melasma were recruited into this study and randomized into two groups. Group A consisting of 20 patients received TC cream once daily for night time application for 3 months. Group B comprising of 20 patients received GA/AA 20% cream combination for 3 months. The disease severity was monitored with digital photography, melasma area and severity index (MASI) score which was calculated at baseline, 6 weeks and 12 weeks, and visual analogue scale (VAS) score which was calculated at baseline and 12 weeks.
Results – Of 40 patients, 38 completed the study. A significant reduction in MASI and VAS was recorded after 6 weeks and 12 weeks of treatment in both group A and group B (P=0.001). However, there was no difference in the mean MASI scores between the two groups at baseline, 6 weeks and 12 weeks. Similarly, there was no difference in the mean VAS scores between the two groups at baseline and 12 weeks. Four patients in group A and 3 in group B experienced adverse effects like irritation, dryness and photosensitivity.
Conclusions – Both TC cream and GA/AA 20% cream combination are equally effective in treating melasma among Indian patients.