Comparing Kojic Acid Cream 2% with Glycolic Acid 10% and Hydroquinone Cream 2% in Treatment of Melasma

Document Type : Original Article (s)

Authors

1 Associate Professor, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan,Iran

2 Professor, Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

4 Associate Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran AND Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Melasma is a common acquired hypermelanosis in areas exposed to sunlight, which exacerbates with sunlight, pregnancy, and endocrine diseases. Melasma is problematic regarding cosmetic especially in women. Many drugs have been used for its treatment, but regarding side effects, they have limited relative usage. Therefore, testing a new drug with higher effectiveness and fewer side effects is necessary. This study attempted to evaluate the effectiveness of kojic acid on melasma.Methods: In this study double-blind clinical trial study, 40 patients with melasma were enroled. One group of 20 people received kojic acid cream 2%, and the other used glycolic acid 10% and hydroquinone cream 2%. In the first group, 43 pigmented macules and in the second group, 21 pigmented macules existed. The changes of pigments in terms of recovery time, color tone and size of the pigments over a three-month treatment period was evaluated with clinical assessment, completing monthly questionnaire, and in a few cases with the aid of Wood's lamp. After the three-month treatment period, the collected data using the Friedman test, t-test were analyzed.Findings: In total, 79% of the patients were cured after 3 months. According to Friedman test, regarding healing time of the pigment, there was a significant difference between the groups (P = 0.008). Regarding the color tone changes of the pigment at the end of the second and third months, there was a significant difference between the two groups.Conclousion: Kojic acid 2% cream has a good efficacy in the treatment of melasma with no serious complications.

Keywords

References

  1. Grimes PE, Yamada N, Bhawan J. Light microscopic, immunohistochemical, and ultrastructural alterations in patients with melasma. Am J Dermatopathol 2005; 27(2): 96-101.
  2. Mosher DB, Fitzpatric TB, Hori Y, Ortonne JP. Disorder of melanocyte. In: Fitzpatrick TB, Freedberg IM, Editors. Fitzpatricks dermatology in general medicine. New York, NY: McGraw-Hill Medical Publishing Division; 2003. p. 903-87.
  3. Martin AG, Leal-Khouri S. Physiologic skin changes associated with pregnancy. Int J Dermatol 1992; 31(6): 375-8.
  4. Vazquez M, Sanchez JL. The efficacy of a broad-spectrum sunscreen in the treatment of melasma. Cutis 1983; 32(1): 92, 95-2, 96.
  5. Rendon M, Berneburg M, Arellano I, Picardo M. Treatment of melasma. J Am Acad Dermatol 2006; 54(5 Suppl 2): S272-S281.
  6. Astaneh R, Farboud E, Nazemi MJ. 4% hydroquinone versus 4% hydroquinone, 0.05% dexamethasone and 0.05% tretinoin in the treatment of melasma: a comparative study. Int J Dermatol 2005; 44(7): 599-601.
  7. Espinal-Perez LE, Moncada B, Castanedo-Cazares JP. A double-blind randomized trial of 5% ascorbic acid vs. 4% hydroquinone in melasma. Int J Dermatol 2004; 43(8): 604-7.
  8. Guevara IL, Pandya AG. Safety and efficacy of 4% hydroquinone combined with 10% glycolic acid, antioxidants, and sunscreen in the treatment of melasma. Int J Dermatol 2003; 42(12): 966-72.
  9. Prignano F, Ortonne JP, Buggiani G, Lotti T. Therapeutical approaches in melasma. Dermatol Clin 2007; 25(3): 337-42, viii.
  10. Balina LM, Graupe K. The treatment of melasma. 20% azelaic acid versus 4% hydroquinone cream. Int J Dermatol 1991; 30(12): 893-5.
  11. Verallo-Rowell VM, Verallo V, Graupe K, Lopez-Villafuerte L, Garcia-Lopez M. Double-blind comparison of azelaic acid and hydroquinone in the treatment of melasma. Acta Derm Venereol Suppl (Stockh) 1989; 143: 58-61.
  12. Lynde CB, Kraft JN, Lynde CW. Topical treatments for melasma and postinflammatory hyperpigmentation. Skin Therapy Lett 2006; 11(9): 1-6.
  13. Jimbow K. N-acetyl-4-S-cysteaminylphenol as a new type of depigmenting agent for the melanoderma of patients with melasma. Arch Dermatol 1991; 127(10): 1528-34.
  14. Arora P, Sarkar R, Garg VK, Arya L. Lasers for treatment of melasma and post-inflammatory hyperpigmentation. J Cutan Aesthet Surg 2012; 5(2): 93-103.
  15. Zhou X, Gold MH, Lu Z, Li Y. Efficacy and safety of Q-switched 1,064-nm neodymium-doped yttrium aluminum garnet laser treatment of melasma. Dermatol Surg 2011; 37(7): 962-70.
  16. Wattanakrai P, Mornchan R, Eimpunth S. Low-fluence Q-switched neodymium-doped yttrium aluminum garnet (1,064 nm) laser for the treatment of facial melasma in Asians. Dermatol Surg 2010; 36(1): 76-87.
  17. Lim JT. Treatment of melasma using kojic acid in a gel containing hydroquinone and glycolic acid. Dermatol Surg 1999; 25(4): 282-4.
  18. Choi H, Kim K, Han J, Choi H, Jin SH, Lee EK, et al. Kojic acid-induced IL-6 production in human keratinocytes plays a role in its anti-melanogenic activity in skin. J Dermatol Sci 2012; 66(3): 207-15.
  19. Sheth VM, Pandya AG. Melasma: a comprehensive update: part II. J Am Acad Dermatol 2011; 65(4): 699-714.
  20. Sarkar R, Chugh S, Garg VK. Newer and upcoming therapies for melasma. Indian J Dermatol Venereol Leprol 2012; 78(4): 417-28.
  21. Cotellessa C, Peris K, Onorati MT, Fargnoli MC, Chimenti S. The use of chemical peelings in the treatment of different cutaneous hyperpigmentations. Dermatol Surg 1999; 25(6): 450-4.
  22. Garcia A, Fulton JE. The combination of glycolic acid and hydroquinone or kojic acid for the treatment of melasma and related conditions. Dermatol Surg 1996; 22(5): 443-7.
Journal of Isfahan Medical School
Volume 31, Issue 269 - Serial Number 269
November and December 2014
Pages 2295-2330

Files

History

  • Receive Date: 09 January 2013
  • Revise Date: 25 May 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics