Open-label treatment of moderate or marked melasma with a 4% hydroquinone skin care system plus 0.05% tretinoin cream

Abstract

Objective: To evaluate treating epidermal melasma using a 4% hydroquinone skin care system plus tretinoin 0.05% cream.

Design: Multicenter open-label study with all patients receiving above-mentioned treatment for up to 24 weeks.

Setting: Private dermatology and plastic surgery clinics and clinical research facilities.

Participants: Thirty-seven adult females with moderate or marked epidermal melasma, melasma pigmentation of mild-to-marked intensity and Fitzpatrick skin type III to VI.

Measurements: Melasma severity melasma pigmentation intensity melasma improvement, patient satisfaction, quality-of-life measures, erythema, dryness, peeling, burning/stinging.

Results: No patient discontinued due to lack of efficacy or treatment-related adverse events. Treatment was associated with a significant reduction from baseline in melasma severity and melasma pigmentation intensity from Week 4 onward (P≤0.001), and 100 percent of patients showed improvement from Week 8 onward. At Week 24, 100 percent of patients were "satisfied" or "very satisfied" with the overall effectiveness of their treatment. Patients' quality of life also improved (e.g., the proportion of patients feeling embarrassed or self-conscious about their skin "a lot" or "very much" declined from 78 percent at baseline to four percent at Week 24). Mean and median scores for erythema, dryness, peeling, and burning/stinging did not exceed trace levels.

Conclusion: Treating moderate-to-severe melasma using the 4% hydroquinone skin care system plus 0.05% tretinoin can significantly reduce the severity of melasma and the intensity of melasma pigmentation within four weeks. Treatment was generally well tolerated and associated with an improved quality of life and high levels of patient satisfaction.

Figure 1

Improvements in melasma

Figure 2

Melasma severity

Figure 3

Melasma pigmentation intensity

Figure 4

Degree of improvement in melasma

Figure 5

Patient perceptions at Week 24

Figure 6

Improvement in quality-of-life parameters

Figure 7

Patient-reported improvements at Week 24