Comparison of effectiveness and safety of topical 30% metformin versus 4% hydroquinone in the treatment of epidermal melasma
Keywords:
Epidermal, Melasma, Metformin, HydroquinoneAbstract
Objective To compare the effectiveness and safety of topical 30% metformin versus 4% hydroquinone in the treatment of epidermal melasma. Methods The study was a randomized controlled trial conducted at Outpatient Department of Dermatology Unit II, Mayo Hospital Lahore over a duration of six months. A total of 62 patients were enrolled from the outpatient Dermatology department as per inclusion and exclusion criteria. Two equal groups were formed randomly by lottery system, as group A and group B. In Group-A patients were advised to apply 30% Metformin cream over the affected area on the face at night and sunscreen of SPF 30 in the morning for a period of 12 weeks and in Group-B patients were advised to apply 4% Hydroquinone cream over the affected area on the face at night and sunscreen of SPF 30 in the morning for 12 weeks. Patients were asked to come for follow-up every 4 weeks till completion of the treatment (till 12 weeks) and last follow up was done one month after the last treatment session (at 16th week). All patients’ photographs were taken before and after starting the therapy. MASI score for all patients was calculated at each visit. Percentage of improvement was calculated by deducting MASI score from pretreatment MASI score and dividing it by post-treatment MASI score. Results Mean age of patients in Group-A and B was 41.29±13.01 years and 36.16±11.46 years. Among these patients 16 (25.81%) were male and 46 (74.19%) were female. The male to female ratio was 2:6. Mean percentage reduction in MASI score in Group-A and B was 60.28±14.04 and 55.02±13.35, respectively. As per efficacy criteria patients treated with metformin had higher efficacy as compared to patients treated with hydroquinone. i.e. Group-A: 80.6% vs. Group-B: 58.1%, p-value=0.054. No significant difference was seen for hypopigmentation and swelling between both groups from 1st month till 4th month follow up post treatment. Conclusion The present study showed that 30% topical metformin is more effective and safe as compared to 4% hydroquinone in the treatment of epidermal melasma.References
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