Pimpa Tantanasrigul1 | Apinya Sripha1 | Bunchai Chongmelaxme21

Department of Medical Services, Ministry of Public Health, Institute of Dermatology, Bangkok, Thailand | 2Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand

Correspondence: Bunchai Chongmelaxme (该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。)

Received: 5 July 2024 | Accepted: 22 August 2024

Funding: The authors received no specific funding for this work.

Keywords: alpha-arbutin 5% | efficacy | kojic acid 2% | melasma | safety | triple combination cream

ABSTRACT

Background: While the gold standard treatment for melasma is triple combination cream (TCC), arbutin and kojic acid demonstrate their benefits and may be used as an alternative.

Aims: To investigate the efficacy of cream containing alpha-arbutin 5% and kojic acid 2% (AAK) compared with TCC for melasma treatment.

Patients/Methods: A split-faced, randomized study was conducted among 30 participants with melasma, and all were randomized to receive AAK or TCC on each side of their face for 12-week along with 4-week follow-up period. The melanin index (MI), modified Melasma Area Severity Index (mMASI), and physician global assessment (PGA) scores were used to measure the effectiveness of interventions. Recurrence of melasma after treatment discontinuation was evaluated by MI and mMASI. Patient satisfactions and adverse effects were also evaluated. In the analysis, the mean difference (MD) was used for MI and mMASI, while Wilcoxon signed-rank test was for the PGA scores, adverse effects, and patient satisfaction.

Results: The MD of MI and mMASI scores were not different between groups (mMASI [p=0.344] and MI [p=0.268]). The PGA scores only showed improvement on the TCC-treated side (p=0.032). Compared to the AKK group, the subjects with TCC showed higher severity of recurrence (MI [p=0.004] and mMASI [p=0.045]). No difference in patient satisfaction score between the groups, but erythema and stinging were higher in the TCC group.

Conclusions: The AAK cream appeared to be effective for melasma treatment, highlighting a lower recurrent rate and fewer adverse events than standard therapy.

Trial Registration: thaiclinicaltrials.org: TCTR20230124004

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

© 2024 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.